Peter Byung-Hoon Kang, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

ME117461 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 273-8920

Fax

(617) 730-0279

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkang633396@fairview.direct-ci.com

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Specialty Services

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1588543862
  Medicare reassignment
• Fairview Express Care

  • Specialist
  • Saint Paul, MN
  • NPI 1679048763
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1992723191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-273-8920",
            "fax_number": "617-730-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-8920",
            "fax_number": "617-730-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "PETER",
        "middle_name": "BYUNG-HOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "214097",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "214097",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MA",
            "license": "214097",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME117461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0198471",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009815500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Kanary, PHARMD
• Jesse A. Kane, M.D.
• Andy Kang, DDS
• Johana Kang
• Kyongdeuk Kang, M.D.
• Meena Kanhai
• Wendy L Kanner, ARNP
• Bhargav Kansara
• Austin Kansol, MD
• Sowmya Kantamneni, M.D.

• Neurology with Special Qualifications in Child Neurology Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.