Individual provider Active NPI

Jeffrey Ling Kang, MD

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1710429410
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME131236 Issued in FL
Practice address
1000 Park Centre Blvd
Miami, FL 33169-5373
Phone
(305) 621-0023
NPI assigned
Nov 11, 2016
Last updated
Nov 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43186 CT
Internal Medicine Physician 207R00000X ME131236 FL Primary

Addresses

Primary practice location

1000 Park Centre Blvd
Miami, FL 33169-5373

Mailing address

1395 NW 167TH St
Miami, FL 33169-5742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, OR, WI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220928003490 UT Practitioner - Internal Medicine 8729231261 Reassigns benefits to 1 organization
I20230719000290 OR Practitioner - Internal Medicine 8729231261 Reassigns benefits to 1 organization
I20250106000260 WI Practitioner - Internal Medicine 8729231261 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43186CTMDInternal Medicine Physician
ME131236FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Utah LLC Internal Medicine CurrentSince Aug 3, 2022 Accepting new patients
Wellbe Wisconsin SC Internal Medicine CurrentSince Nov 10, 2024 Accepting new patients
Wellbe Alabama LLC Internal Medicine PastSince Feb 1, 2024 Accepting new patients
Walgreen Co PastSince Apr 30, 2003 Accepting new patients
Jencare Neighborhood Medical Center Evergreen Park, LLC Past Accepting new patients

Locations

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220

250 E 200 S
Fl 16
Slc, UT 84111
Phone (312) 776-2422

209 S Central Ave
Marshfield, WI 54449
Phone (715) 354-0310

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1710429410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PARK CENTRE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695373",
            "telephone_number": "305-621-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JEFFREY",
        "middle_name": "LING",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-11",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "43186",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME131236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.