Luke Chang-Dae Kang, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

192721 Issued in CA

Practice address

260 Hospital Dr Ste 209
Ukiah, CA 95482-4568

Phone

(707) 463-7483

NPI assigned

Apr 2, 2021

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GU

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 1

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ukiah Adventist HospitalGroup PAC ID 6406816123, shared by 5 NPIs, 136 clinicians

General Conference Corp of SdaGroup PAC ID 6608777628, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: luke.kang.1@31775.direct.athenahealth.com

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.

• General Conference Corp of Sda

  dba Guam Seventh-Day Adventist Clinic

  • Clinic/Center
  • Tamuning, GU
  • NPI 1275586877
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ukiah Adventist Hospital

  dba Adventist Health Ukiah Valley

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1811576358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 209",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-463-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 209",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-463-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "LUKE",
        "middle_name": "CHANG-DAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "TLL-2024-003",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "192721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Joseph, DO
• Kirsten Quitno Juliet, M.D.
• Michael Jung, MD
• Thomas Jutzy, D.D.S.
• Bradley J Kammer, MFT
• Hope Kargel
• Brandon Karns
• Kelly L Kartub, MFT
• Lori Katnik, FNP
• Julia Regina Katsuura, MD

• Family Medicine Physician in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.