Chang Woon Kang, M.D.
Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · Golden, CO
NPI 1689675852 · NPPES record last updated Jul 13, 2016
Key facts
- NPI
- 1689675852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- License
- 43586 (CO)
- Practice address
- 5920 McIntyre St
Golden, CO 80403-7445 - Phone
- (303) 949-1250
- Fax
- (303) 215-7308
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051116000227 | CO | Practitioner - Internal Medicine |
8022070572 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43586 | CO | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inpatient Consultants of Colorado, PC | Past | Accepting new patients | |
| Senior Care of Colorado, PC | Geriatric Medicine | Past |
Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Hearts With Integrity LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 43586 | CO | Yes |
Addresses
Primary practice location
5920 McIntyre St
Golden, CO 80403-7445
Mailing address
5920 McIntyre St
Golden, CO 80403-7445
Phone (303) 949-1250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46885064 | Medicaid | CO |
Other names
- C Thomas Kang
Other providers in Golden, CO
- Joy and Play LLC
- Julie Poelchau, LLC
- Marilu B Kaisershot
- Lynn B Kalert
- Dthia Alice Kalkwarf
- Robert Scott Kantor
- Arti Karna
- Sushanthi Katta
- Sam S Kawakami
- Jaime Kaye
All providers in Golden, CO · Geriatric Medicine (Internal Medicine) Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.