LARA KANG AGACNP - NPI 1841897394 - Nurse Practitioner in Saint Louis, MO

Q: What is Lara Kang's NPI number?

The NPI number for Lara Kang is 1841897394. It was assigned to this individual provider in the NPPES registry on October 7, 2020. The provider is also known as Lara Adelby.

Q: What is Lara Kang's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Lara Kang was last updated on June 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

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About Lara Kang Agacnp NPPES

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

LARA KANG AGACNP (NPI 1841897394) is an individual acute care provider in Saint Louis, Missouri, licensed in Missouri (2020018091) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1841897394

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameLARA KANGCredential: AGACNP

Location Address12700 SOUTHFORK RD STE 280Saint Louis, MO 63128-3287

Mailing Address12700 Southfork Rd Ste 280Saint Louis, MO 63128-3287 · (314) 892-6565 · Fax (314) 892-4828

Phone(314) 892-6565

Fax(314) 892-4828

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 7, 2020

Last NPPES UpdateJune 2, 20264 updates tracked since enumeration

NPPES CertifiedJune 2, 2026

✔ NPI 1841897394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in MO · 2020018091

12700 SOUTHFORK RD STE 280, Saint Louis, MO 63128

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Other Names 1

Former Name (1)Lara Adelby

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lara Kang Agacnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7113366394

PECOS Enrollment IDI20240420000215

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

HANNAH ANN WUELLNER AGACNP

Nurse Practitioner (Acute Care)