Organization Active NPI

KSB Gastroenterology

  • Gastroenterology Physician
  • Irvine, CA
National Provider Identifier
1881023257
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A101486 Issued in CA
Legal business name
KSB GASTROENTEROLOGY
Practice address
33 Creek Rd
Suite 380
Irvine, CA 92604-4791
Phone
(949) 517-8669
NPI assigned
Nov 6, 2013
Last updated
Nov 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Authorized official

Name
Kong Peng Yap, M.D.
Title
Owner
Phone
(949) 517-8669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A101486 CA Primary

Addresses

Primary practice location

33 Creek Rd
Suite 380
Irvine, CA 92604-4791

Mailing address

33 Creek Rd
Suite 380
Irvine, CA 92604-4791
Phone (949) 517-8669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140313000832 CA Part B Supplier - Clinic/Group Practice 3072743020 Receives reassigned benefits from 1 practitioner
Practice locations: Irvine, CA

National Provider Directory

National Provider Directory

Locations

33 Creek Rd
Ste 380
Irvine, CA 92604
Phone (949) 517-8669

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1881023257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CREEK RD",
            "address_2": "SUITE 380",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044791",
            "telephone_number": "949-517-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CREEK RD",
            "address_2": "SUITE 380",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044791",
            "telephone_number": "949-517-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSB GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "YAP",
        "authorized_official_first_name": "KONG",
        "authorized_official_middle_name": "PENG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-517-8669",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A101486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.