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SHANA STACY KONG MD
NPI 1215796438
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since March 18, 2024PECOS Enrolled
1200 N STATE ST # GH3900, LOS ANGELES, CA 90089(323) 409-7210 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shana Stacy Kong Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANA STACY KONG MD (NPI 1215796438) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215796438
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSHANA STACY KONGCredential: MD
Location Address1200 N STATE ST # GH3900Los Angeles, CA 90089-1001
Mailing Address1200 N State St # Gh3900Los Angeles, CA 90089-1001
Phone(323) 409-7210
Sole ProprietorYes
Enumeration DateMarch 18, 2024
NPPES CertifiedMarch 18, 2024
✔ NPI 1215796438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1200 N STATE ST # GH3900, Los Angeles, CA 90089
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shana Stacy Kong Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN PALMER
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (408) 499-2507
JEREMY SIU
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (213) 923-2689
ELAN AARON KARLIN
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7210
RAJKO SLOBODAN VUCICEVIC
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (630) 247-0206
KEVIN ALI MOATTARI MD
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7210
BENJAMIN WALTER VAN MD
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (408) 425-5550
FERGUI HERNANDEZ
Student in an Organized Health Care Education/Training Program
1200 N STATE ST # GH3900
LOS ANGELES, CA 90089
Los Angeles County (323) 409-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shana Kong's NPI number?

The NPI number for Shana Kong is 1215796438. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Where is Shana Kong located?

Shana Kong practices at 1200 N State St # Gh3900, Los Angeles, CA 90089. The listed phone number is (323) 409-7210.

What is Shana Kong's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shana Kong enrolled in Medicare?

Yes. Shana Kong is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shana Kong was last updated on March 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.