Individual provider Active NPI

Jason Lee Kang, M.D.

  • Emergency Medicine Physician
  • Payson, AZ
National Provider Identifier
1932390457
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
32583 Issued in AZ
Practice address
807 S Ponderosa St
Payson, AZ 85541-5542
Phone
(602) 386-9982
Fax
(484) 231-9982
NPI assigned
Aug 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 32583 AZ Primary
Internal Medicine Physician 207R00000X 32583 AZ

Addresses

Primary practice location

807 S Ponderosa St
Payson, AZ 85541-5542

Mailing address

PO Box 15070
Scottsdale, AZ 85267-5070
Phone (480) 421-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20110208000200 AZ Practitioner - Emergency MedicinePractitioner - Internal Medicine 0345420493 Reassigns benefits to 3 organizations
I20171019000490 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 0345420493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Acute Medical Services 1 PCGroup PAC ID 6204113970, 49 clinicians

Practice addresses (Care Compare)

16815 W Bell Rd
Surprise, AZ 85374-2101
Phone (615) 665-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32583AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Arizona Professional Corporation Emergency Medicine CurrentSince Jan 13, 2015 Accepting new patients
Texas Emergency Medicine Group, LLP Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Mountain Vista Emergency Physicians, LLC Emergency Medicine CurrentSince Jan 10, 2023 Accepting new patients
Key Medical Solutions LLC Internal Medicine Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients

Locations

4545 N Hunt Hwy
Florence, AZ 85132
Phone (480) 258-6100

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

5750 E Baseline Rd
Mesa, AZ 85206
Phone (602) 246-5797

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

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

2000 W Bethany Home Rd
#R
Phoenix, AZ 85015

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

16815 W Bell Rd
Surprise, AZ 85374
Phone (623) 244-2400

1301 Montgomery Rd
Graham, TX 76450
Phone (940) 521-5360

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1932390457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15070",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852675070",
            "telephone_number": "480-421-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S PONDEROSA ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415542",
            "telephone_number": "602-386-9982",
            "fax_number": "484-231-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2025-03-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "32583",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "32583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

Verify at the official NPI Registry.