SONG KANG (PHYSICIAN ASSISTANT) – Medical Physician Assistant, NPI 1366927741

SONG KANG (PHYSICIAN ASSISTANT) is a healthcare provider. based in Decatur, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. They hold a License No. 085006761 (IL). The NPI Number for SONG KANG (PHYSICIAN ASSISTANT) is 1366927741

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
SONG KANG (PHYSICIAN ASSISTANT)
NPI
1366927741
Phone
(618) 201-9860
Address
3727 N NORTHHAVEN CT APT 2A
Enumeration Date
1 October 2018
Last Update Date
10 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2175882600
Graduation Year
2018 (8 years ago)
PAC ID
4587083829
Group Practice PAC ID
9032005681
Professional Enrollment ID
I20230105001409
Address ID
IL626298047CH101XXBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:7State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for SONG KANG (PHYSICIAN ASSISTANT)

  • 3727 N NORTHHAVEN CT APT 2A

    DECATUR, IL 625269250

    Phone: (618) 201-9860

    Type: Mailing

  • 320, Central Avenue, Phoenix Park, Longview Place, Decatur, Macon County, Illinois, 62521, United States

    DECATUR, IL 625214665

    Phone: (217) 877-4694

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-01-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230105001409IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9492$0
99203New patient office or other outpatient visit, 30-44 minutes3131$0
99214Established patient office or other outpatient visit, 30-39 minutes3030$0
99204New patient office or other outpatient visit, 45-59 minutes1414$0
81002Urinalysis, manual test1311$0
View full utilization report →

Insurance plans in this area (ZIP 62526)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032005681View full group profile
NameSpecialtyState
Family PracticeNJ
Nurse PractitionerIL
Family PracticeIL
Nurse PractitionerIL
Vascular SurgeryIL
Nurse PractitionerIL
Physician AssistantIL
-IL
Mental Health CounselorIL
-IL

Reviews

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Frequently asked questions

Is SONG KANG (PHYSICIAN ASSISTANT) listed with a National Provider Identifier?
Yes — SONG KANG (PHYSICIAN ASSISTANT) has NPI 1366927741 on file in the registry.
Is there an active status for SONG KANG (PHYSICIAN ASSISTANT)?
For scheduling context, SONG KANG (PHYSICIAN ASSISTANT) is shown as active in the registry.
What kind of doctor is SONG KANG (PHYSICIAN ASSISTANT)?
SONG KANG (PHYSICIAN ASSISTANT) is associated with Medical Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Is SONG KANG (PHYSICIAN ASSISTANT) located near Decatur?
SONG KANG (PHYSICIAN ASSISTANT) currently maps to Decatur, Illinois in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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