PAUL BYUNGHUN KANG - NPI 1417657305 - Physician Assistant in Phoenix, AZ

Q: What is Paul Kang's NPI number?

The NPI number for Paul Kang is 1417657305. It was assigned to this individual provider in the NPPES registry on March 8, 2023.

Q: What is Paul Kang's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Paul Kang was last updated on August 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Paul Byunghun Kang NPPES

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

PAUL BYUNGHUN KANG (NPI 1417657305) is an individual surgical provider in Phoenix, Arizona, licensed in Arizona (11122) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1417657305

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NamePAUL BYUNGHUN KANG

Location Address500 W THOMAS RD STE 750&850Phoenix, AZ 85013-4224

Mailing AddressPo Box 33269Phoenix, AZ 85067-3269 · (602) 406-4786 · Fax (916) 636-4358

Phone(602) 406-1150

Fax(602) 406-1159

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMarch 8, 2023

Last NPPES UpdateAugust 27, 20253 updates tracked since enumeration

NPPES CertifiedAugust 27, 2025

✔ NPI 1417657305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in AZ · 11122

Also ListedPhysician AssistantTaxonomy 363A00000X · License 11122 (AZ), 085009645 (IL)

500 W THOMAS RD STE 750&850, Phoenix, AZ 85013

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Secondary Practice Locations 3

Location 1611 W Park StUrbana, IL 61801-2529 · Phone (217) 383-3311

Location 2485 S Dobson Rd Ste 203Chandler, AZ 85224-5604 · Phone (480) 728-2690 · Fax (480) 728-2689

Location 3305 W Jackson St Ste 206Carbondale, IL 62901-1474 · Phone (618) 457-5200 · Fax (618) 457-5200

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Paul Byunghun Kang is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234599580

PECOS Enrollment IDI20250924003192

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services13 patients

Coronary artery bypass using artery graft, 1 graft 33533

A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.

11 services11 patients

Other Providers at the Same Location NPPES 11

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

KELLY WESSELHOFF ACNP

Nurse Practitioner (Acute Care)