Kudo Jang, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

97233 Issued in GA

Practice address

100 Lacy St NW Ste 150
Marietta, GA 30060-1273

Phone

(770) 793-7635

Fax

(770) 793-7645

NPI assigned

Mar 25, 2019

Last updated

Dec 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

Medical College of Georgia School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Kennestone Inpatient Rehab Inpatient rehabilitation facility, Marietta, GA, CCN 11T035

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjang531261@directwellstar.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Kennestone Hospital, Inc

  dba WellStar Kennestone Hospital Inpatient Rehab Unit

  • Rehabilitation Hospital Unit
  • Marietta, GA
  • NPI 1578553343

  Inpatient rehabilitation facility

  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Wellstar Home Health, LLC

  dba WellStar Home Health

  • Home Health Agency
  • Marietta, GA
  • NPI 1073591376
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1518428408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LACY ST NW STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601273",
            "telephone_number": "770-793-7635",
            "fax_number": "770-793-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LACY ST NW STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601273",
            "telephone_number": "770-793-7635",
            "fax_number": "770-793-7645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Westview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303101458",
            "country_code": "US",
            "telephone_number": "404-756-1313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 Shady Grove Ln",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300093247",
            "country_code": "US",
            "telephone_number": "770-905-5412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANG",
        "first_name": "KUDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "97233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjang531261@directwellstar.org",
            "affiliation": "N",
            "address_1": "100 Lacy St NW Ste 150",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zaid Jamil, DO
• Amna Jamshad, DO
• Bita Jamshidi
• Roya Jamshidi, DC
• Kimberly Janflone, PA
• Rajae A Janho, MD
• Mary Elizabeth Janousek, CCC-SLP
• Robert David Jansen, M.D.
• Sharon M January, MD
• Rubi Itzel Jaquez

• Physical Medicine & Rehabilitation Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.