Individual provider Active NPI

Mi Hwa Kang, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Fairfax, VA
National Provider Identifier
1649371014
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
0101038929 Issued in VA
Practice address
3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone
(703) 391-3129
Fax
(703) 766-9725
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 0101038929 VA Primary

Addresses

Primary practice location

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709

Mailing address

3998 Fair Ridge Dr
Ste 300
Fairfax, VA 22033-2921
Phone (703) 766-9737

Other identifiers 8

IdentifierTypeStateIssuer
1047026OtherWAWORKER'S COMPENSATION
297594OtherVAAMERIGROUP
4526-8625OtherVACARE FIRST
K142-0001OtherVACARE FIRST 2005
484645OtherVANCPPO
286296OtherVAANTHEM
050084074OtherVARAILROAD MEDICARE
1649371014MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050728000470 VA Practitioner - Anesthesiology 7416985700 Reassigns benefits to 2 organizations
I20090608000175 DC Practitioner - Anesthesiology 7416985700 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101041293VAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Cares - Community CurrentSince Jun 12, 2023 Accepting new patients
American Anesthesiology of Virginia PC Pain Medicine CurrentSince May 1, 2021 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince May 1, 2021 Accepting new patients
Spectrum Anesthesia Services LLC Past Accepting new patients

Locations

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Interoperability endpoints

  • Direct secure messaging: mkang60910@soc.inova.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1649371014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-766-9737",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 JOSEPH SIEWICK DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331709",
            "telephone_number": "703-391-3129",
            "fax_number": "703-766-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MI",
        "middle_name": "HWA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101038929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "1047026",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "297594",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "4526-8625",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST 2005",
            "identifier": "K142-0001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "484645",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "286296",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050084074",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649371014",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.