Edwin Kang, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00436000 Issued in NJ

Practice address

617 Broad St
Newark, NJ 07102-4403

Phone

(862) 246-7940

NPI assigned

May 17, 2017

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

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwin.kang.1@2983.direct.athenahealth.com

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

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• The Radiology Group of New Jersey, LLC

  dba The Medical Group of New Jersey

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  Medicare reassignment NPD
• Doctor's Office of West Caldwell LLC

  • Urgent Care Clinic/Center
  • West Caldwell, NJ
  • NPI 1144524786
  Medicare reassignment
• Doctors Office of Brick

  • Urgent Care Clinic/Center
  • Brick, NJ
  • NPI 1184067944
  Medicare reassignment
• Excel Urgent Care of Paramus LLC

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1063652220
  Medicare reassignment
• Nes Georgia Inc

  • Emergency Medicine Physician
  • Elizabeth, NJ
  • NPI 1043616675
  Medicare reassignment
• Pegasus Emergency Group PA

  • Emergency Medicine Physician
  • Flemington, NJ
  • NPI 1336179621
  Medicare reassignment
• Nes Georgia Inc

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1912411331
  NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Monmouth Digestive Health LLC

  • Gastroenterology Physician
  • Eatontown, NJ
  • NPI 1831721232
  NPD (past)

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1598292815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "08844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024403",
            "telephone_number": "862-246-7940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071021909",
            "country_code": "US",
            "telephone_number": "973-887-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "EDWIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00436000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00436000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Kaminskyj, PA
• Mani Teja Kamireddy
• Valerie Kampo, COTA/L
• Harshita Kandarpa, DO
• Eman Kandil, LSW
• Justin Y Kang, L.AC
• Nathan Kang, DO
• Sebastian Kang, RRT
• Uma Kanikicharla, M.D
• Joshua Michael Kaplan, M.D.

• Physician Assistant in Newark, NJ
• Providers in Newark, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.