Individual provider Active NPI

Melissa Kang

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1700048154
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
279678-1 Issued in NY
Practice address
10 Union SQ E
New York, NY 10003-3314
Phone
(212) 420-4015
Fax
(212) 844-6332
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201101316 NC
Gastroenterology Physician 207RG0100X FK2770902 ME
Gastroenterology Physician 207RG0100X 279678-1 NY Primary

Addresses

Primary practice location

10 Union SQ E
New York, NY 10003-3314

Mailing address

915 Hillside Ave
New Hyde Park, NY 11040-2529

Other practice location 1

915 Hillside Ave
New Hyde Park, NY 11040-2529
Phone (516) 437-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20151007003059 NY Practitioner - Gastroenterology 5193999464 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy Place
New York, NY 10029-6574
Phone (212) 987-3100

1000 10TH Ave
New York, NY 10019-1147
Phone (212) 523-3657

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-3657

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Upper gastrointestinal (GI) endoscopy for acid reflux14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201101316NCMDInternal Medicine Physician
279678-1NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Digestive Disease Care, PC Gastroenterology CurrentSince Jun 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince Sep 2, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

380 2nd Ave
New York, NY 10010
Phone (212) 253-6600

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

915 Hillside Ave
North New Hyde Pk, NY 11040
Phone (516) 437-9000

11014 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 335-4747

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1700048154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HILLSIDE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-420-4015",
            "fax_number": "212-844-6332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110402529",
            "country_code": "US",
            "telephone_number": "516-437-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201101316",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "FK2770902",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "279678-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.