Individual provider Active NPI

Susan Kang, NP

  • Adult Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1760626030
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP18556 Issued in CA
Practice address
200 Medical Plaza
Suite 214
Los Angeles, CA 90095-0001
Phone
(310) 794-7788
Fax
(310) 206-4197
NPI assigned
Apr 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP18556 CA Primary

Addresses

Primary practice location

200 Medical Plaza
Suite 214
Los Angeles, CA 90095-0001

Mailing address

200 Medical Plaza
Suite 214
Los Angeles, CA 90095-0001
Phone (310) 794-7788

Other identifiers 1

IdentifierTypeStateIssuer
RN649046MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090908000408 CA Practitioner - Nurse Practitioner 5395890727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 7911970736, 38 clinicians

Practice addresses (Care Compare)

757 Westwood PLZ
Los Angeles, CA 90095-8358

950 Charles Young Dr
Suite 77 120
Los Angeles, CA 90095-0001
Phone (310) 825-5318

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.27 of 100Reported as group
Quality
60.66
Promoting interoperability
100
Improvement activities
40
Cost
80.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18556CAMDPediatric Physical Therapist
NP18556CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Feb 20, 2012 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

200 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-6688

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

File 54206
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

200 UCLA Medical Plz
Ste 214
Los Angeles, CA 90095
Phone (310) 794-7788

Interoperability endpoints

  • Direct secure messaging: skang37716@direct.uclahealth.org

Organizations & group practices 3

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 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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1760626030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "SUITE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-794-7788",
            "fax_number": "310-206-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "SUITE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-794-7788",
            "fax_number": "310-206-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP18556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN649046",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.