NPIMap

Individual provider Active NPI

Ceon Kang, D.O

  • Internal Medicine Physician
  • Sierra Vista, AZ
National Provider Identifier
1861843682
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
008018 Issued in AZ
Practice address
5700 E Highway 90
Sierra Vista, AZ 85635-9110
Phone
(520) 263-2000
NPI assigned
Jun 22, 2016
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 008018 AZ Primary

Addresses

Primary practice location

5700 E Highway 90
Sierra Vista, AZ 85635-9110

Mailing address

289 S Highway 92
2106
Sierra Vista, AZ 85635-3678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA, NM3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190725001735 AZ Practitioner - Internal Medicine 2961738141 Reassigns benefits to 2 organizations
I20191017002046 CA Practitioner - Internal Medicine 2961738141 Reassigns benefits to 2 organizations
I20191113002306 NM Practitioner - Internal Medicine 2961738141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Inpatient Medicine Associates LLCGroup PAC ID 4183688344, 70 clinicians

Practice addresses (Care Compare)

7383 E Tanque Verde Rd
Tucson, AZ 85715-3475
Phone (520) 318-3434

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008018AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansal Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Arizona Inpatient Medicine Associates LLC Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of New Mexico-TCG LLC Internal Medicine CurrentSince Sep 28, 2019 Accepting new patients
Cogent Healthcare of Arizona PC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Sep 28, 2019 Accepting new patients

Locations

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

7383 E Tanque Verde Rd
Tucson, AZ 85715
Phone (520) 318-3434

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-5600

Organizations & group practices 6

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 7

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1861843682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 S HIGHWAY 92",
            "address_2": "2106",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 E HIGHWAY 90",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359110",
            "telephone_number": "520-263-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "CEON",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "008018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.