Moonwha Kang, N.P

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

F340829 Issued in NY

Practice address

845 Palmer Ave Dept of
Mamaroneck, NY 10543

Phone

(914) 864-5857

Fax

(914) 864-5859

NPI assigned

Sep 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, NJ, TX3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD
• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment NPD
• The Hebrew Home for the Aged at Riverdale

  • Skilled Nursing Facility
  • Bronx, NY
  • NPI 1205939667
  NPD (past)

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1790035004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 PALMER AVE DEPT OF",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105432406",
            "telephone_number": "914-864-5857",
            "fax_number": "914-864-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 PALMER AVE DEPT OF",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-864-5857",
            "fax_number": "914-864-5859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 1st Ave",
            "address_2": "15E30",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-6859",
            "fax_number": "212-562-1038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "MOONWHA",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305931",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400150755",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03574701",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Joannou
• Jency John
• Gabriel Antonio Johnson
• JSC Speech-Language Therapy
• Jill Kaiser, LCSW
• William Kaplan, D.D.S.
• Taylor Rose Karbowski
• Jill Karliner, PSY.D.
• Melanie Karol, D.P.T.
• Jaime Karp, LMHC

• Gerontology Nurse Practitioner in Mamaroneck, NY
• Providers in Mamaroneck, NY by specialty
• Gerontology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.