Individual provider Active NPI

Peter Chulhi Kang, MD

  • Surgery Physician
  • Elkhart, IN
National Provider Identifier
1740635887
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01097329A Issued in IN
Practice address
500 Arcade Ave Ste 320
Elkhart, IN 46514-2477
Phone
(574) 523-7900
Fax
(574) 523-7909
NPI assigned
Apr 26, 2016
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01097329A IN Primary

Addresses

Primary practice location

500 Arcade Ave Ste 320
Elkhart, IN 46514-2477

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3437

Other practice location 1

1000 W Carson St # 461
Torrance, CA 90502-2059
Phone (424) 306-8070

Other practice location 2

1020 High Rd
Bremen, IN 46506-1093
Phone (574) 309-9967

Other identifiers 1

IdentifierTypeStateIssuer
300117799MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, IN2 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
I20190812002961 WA Practitioner - General Practice 2163716952 Reassigns benefits to 1 organization
I20250826001237 IN Practitioner - General Surgery 2163716952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

500 Arcade Ave
Suite 320
Elkhart, IN 46514-2477
Phone (574) 523-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Robert Marriott Medical Corp Surgery CurrentSince Jun 5, 2019 Accepting new patients
Beacon Medical Group Inc CurrentSince Sep 15, 2025 Accepting new patients
Beacon Medical Group, Inc. Surgery CurrentSince Sep 15, 2025 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

500 Arcade Ave
Ste 320
Elkhart, IN 46514
Phone (574) 293-3317

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

12509 Greenwood Ave N
Seattle, WA 98133
Phone (206) 361-1989

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1740635887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ARCADE AVE STE 320",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142477",
            "telephone_number": "574-523-7900",
            "fax_number": "574-523-7909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St # 461",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022059",
            "country_code": "US",
            "telephone_number": "424-306-8070",
            "fax_number": "310-533-1841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 High Rd",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "IN",
            "postal_code": "465061093",
            "country_code": "US",
            "telephone_number": "574-309-9967",
            "fax_number": "574-309-9968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "PETER",
        "middle_name": "CHULHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01097329A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300117799",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.