Individual provider Active NPI

Minsoo Kang, MD

  • Neurology Physician
  • Niagara Falls, NY
National Provider Identifier
1780681569
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
002006 Issued in NY
Practice address
4600 Military Rd
Niagara Falls, NY 14305-1338
Phone
(716) 297-8709
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD60858392 WA
Neurology Physician 2084N0400X 002006 NY Primary

Addresses

Primary practice location

4600 Military Rd
Niagara Falls, NY 14305-1338

Mailing address

4600 Military Rd
Niagara Falls, NY 14305-1338
Phone (716) 297-8709

Other identifiers 2

IdentifierTypeStateIssuer
02548516MedicaidNY
2103758MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA, MI3 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
I20040303000398 NY Practitioner - Neurology 9133016249 Reassigns benefits to 2 organizations
I20180725004071 WA Practitioner - Neurology 9133016249 Reassigns benefits to 2 organizations
I20240613002786 MI Practitioner - NeurologyPractitioner - Psychiatry 9133016249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Wny PCGroup PAC ID 5193907517, 207 clinicians

Practice addresses (Care Compare)

192 Park Club LN
Williamsville, NY 14221-5270

2731 Plymouth Rd
Ann Arbor, MI 48105-2427
Phone (734) 255-3185

3435 Bailey Ave
Buffalo, NY 14215-1194
Phone (716) 835-2966

5196 Genesee St
Bowmansville, NY 14026-1038
Phone (716) 817-9952

5300 Military Rd
Lewiston, NY 14092-1903
Phone (716) 297-4800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60858392WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Neurology CurrentSince Aug 1, 2018 Accepting new patients
Trinity Medical Wny PC CurrentSince Oct 21, 2024 Accepting new patients
Trinity Medical Wny PC CurrentSince Oct 21, 2024 Accepting new patients
Mount St. Mary's Hospital of Niagara Falls CurrentSince Jun 27, 2024 Accepting new patients
Hellomed,PLC Neurology CurrentSince Apr 28, 2024 Accepting new patients
Trinity Medical Wny PC Current Accepting new patients
Mount St. Mary's Hospital of Niagara Falls CurrentSince Jun 27, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Apr 6, 2019 Accepting new patients
Multicare Health System CurrentSince Apr 6, 2019 Accepting new patients
Niagara Falls Memorial Medical Center PastSince Dec 22, 2024 Accepting new patients

Locations

2731 Plymouth Rd
Ann Arbor, MI 48105
Phone (734) 255-3185

625 E Liberty St
Ste 10
Ann Arbor, MI 48104
Phone (734) 210-1122

5196 Genesee St
Bowmansville, NY 14026
Phone (716) 206-0005

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

4600 Military Rd
Niagara Falls, NY 14305
Phone (716) 297-8709

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

192 Park Club Ln
Ste 100
Williamsville, NY 14221
Phone (716) 204-0901

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

3600 Lind Ave SW
Ste 100
Renton, WA 98057

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: mkang419679@direct.multicare.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: mkang409492@direct.chsbuffalo.org

Organizations & group practices 11

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1780681569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MILITARY RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143051338",
            "telephone_number": "716-297-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MILITARY RD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143051338",
            "telephone_number": "716-297-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MINSOO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60858392",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "002006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02548516",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103758",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.