Individual provider Active NPI

Kalle Kang, M.D.

  • Gastroenterology Physician
  • Bellevue, WA
National Provider Identifier
1780626630
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD00024250 Issued in WA
Practice address
1135 116TH Ave NE
Suite 560
Bellevue, WA 98004-4623
Phone
(425) 454-4768
Fax
(425) 462-8021
NPI assigned
Jun 12, 2006
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD-24537 HI
Gastroenterology Physician 207RG0100X 77618 TN
Gastroenterology Physician 207RG0100X MD00024250 WA Primary

Addresses

Primary practice location

1135 116TH Ave NE
Suite 560
Bellevue, WA 98004-4623

Mailing address

1135 116TH Ave NE Ste 560
Bellevue, WA 98004-4631

Other practice location 1

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

Other practice location 2

8000 Wolf River Blvd Ste 200
Germantown, TN 38138-1755
Phone (901) 747-3630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID, TN3 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
I20060313000104 WA Practitioner - Gastroenterology 7113828344 Reassigns benefits to 1 organization
I20250606003336 ID Practitioner - Gastroenterology 7113828344 Reassigns benefits to 1 organization
I20260506000361 TN Practitioner - GastroenterologyPractitioner - Internal Medicine 7113828344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 560
Bellevue, WA 98004-4631
Phone (425) 454-4768

746 N College Rd
Twin Falls, ID 83301-3486

775 Pole Line Rd W
Twin Falls, ID 83301-5820

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy107
Upper gastrointestinal (GI) endoscopy for acid reflux91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-24537HIMDGastroenterology Physician
77618TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Gastroenterology PLLC Gastroenterology CurrentSince Dec 15, 2017 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Dec 15, 2017 Accepting new patients
St Luke's Clinic LLC CurrentSince May 27, 2025 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients
Pacific Palisades Podiatry PLLC Past Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients
Public Hospital District No 4 King County Washington Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

1135 116th Ave NE
Ste 560
Bellevue, WA 98004
Phone (425) 467-0150

1135 116th Ave NE
Ste 570
Bellevue, WA 98004
Phone (425) 451-7335

34503 9th Ave S
Ste 240
Federal Way, WA 98003
Phone (253) 838-9839

2727 Hollycroft St
Ste 480
Gig Harbor, WA 98335
Phone (253) 858-0112

1301 4th Ave NW
Ste 301
Issaquah, WA 98027
Phone (425) 270-6363

1301 4th Ave NW
Unit 303
Issaquah, WA 98027
Phone (425) 270-6363

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

11216 Sunrise Blvd E
Ste 3-201
Puyallup, WA 98374
Phone (253) 770-3700

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

1446 Spaulding Ave
Richland, WA 99352
Phone (509) 420-4588

3209 S 23rd St
Ste 200
Tacoma, WA 98405
Phone (253) 503-2508

Organizations & group practices 8

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 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1780626630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 560",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "SUITE 560",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "425-454-4768",
            "fax_number": "425-462-8021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Mahalani St",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967932526",
            "country_code": "US",
            "telephone_number": "808-244-9056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8000 Wolf River Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381755",
            "country_code": "US",
            "telephone_number": "901-747-3630",
            "fax_number": "901-747-4149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "KALLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "MD-24537",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "77618",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00024250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.