PAUL BYUNGHUN KANG – Surgical Physician Assistant, NPI 1417657305
Surgical Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for PAUL BYUNGHUN KANG
611 W Park St
Urbana, IL 618012529
Phone: (217) 383-3311
Type: Location
485 S Dobson Rd Ste 203
Chandler, AZ 852245604
Phone: (480) 728-2690
Fax: (480) 728-2689
Type: Location
305 W Jackson St Ste 206
Carbondale, IL 629011474
Phone: (618) 457-5200
Fax: (618) 457-5200
Type: Location
PO BOX 33269
PHOENIX, AZ 850673269
Phone: (602) 406-4786
Fax: (916) 636-4358
Type: Mailing
500 W THOMAS RD STE 750&850
PHOENIX, AZ 850134224
Phone: (602) 406-1150
Fax: (602) 406-1159
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $33.
Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.
Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Abbott Laboratories ($33).
Total Amount
$33
General + Research + Ownership
Payments
1
Total payment records
General Amount
$33
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $33 |
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: 2025-09-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230718002009 | I | Physician Assistant | IL | TBD |
| I20250924003192 | I | Physician Assistant | AZ | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| - | IL | |
| - | AZ | |
| - | AZ | |
| Pulmonary Disease, Critical Care (Intensivists) | AZ | |
| Diagnostic Radiology | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Colorectal Surgery (Proctology) | AZ | |
| Physician Assistant | AZ |
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