KIBBUM KANG (NURSE PRACTITIONER) – Adult Health Nurse Practitioner, NPI 1548502347
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,307 NURSE PRACTITIONER in VA
Provider Addresses for KIBBUM KANG (NURSE PRACTITIONER)
8640 SUDLEY RD
STE 201
MANASSAS, VA 201104404
Phone: (703) 368-6819
Fax: (703) 330-2923
Type: Mailing
ONE GI CREDENTIALING DEPARTMENT
PO BOX 381468
GERMANTOWN, TN 381831468
Phone:
Type: Mailing
8640 SUDLEY RD STE 201
MANASSAS, VA 201104404
Phone: (703) 368-6819
Fax: (703) 330-2923
Type: Location
170 W Shirley Ave Ste 205
Warrenton, VA 201863083
Phone: (540) 347-2470
Fax: (540) 349-4683
Type: Location
7915 Lake Manassas Dr Ste 302
Gainesville, VA 201553260
Phone: (571) 248-0653
Fax: (571) 248-0658
Type: Location
PO BOX 381468
GERMANTOWN, TN 381831468
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 28 Open Payments records for all available years, with a total value of $929.
Total Amount is formed as General ($929) + Research ($0) + Ownership ($0) = $929.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: ABBVIE INC. ($480).
Total Amount
$929
General + Research + Ownership
Payments
28
Total payment records
General Amount
$929
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $480 |
| Madrigal Pharmaceuticals | $142 |
| Celgene Corporation | $64 |
| Celltrion USA Inc. | $44 |
| Janssen Biotech, Inc. | $30 |
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: 2018-11-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20181114001685 | I | Nurse Practitioner | VA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 80 | 72 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 78 | 78 | $0 |
Insurance plans in this area (ZIP 20110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TN | |
| Gastroenterology, Internal Medicine | TN | |
| P A T H O L O G Y | TN | |
| Physician Assistant | TN | |
| Physician Assistant | TN | |
| G A S T R O E N T E R O L O G Y | VA | |
| Certified Registered Nurse Anesthetist (Crna) | MD | |
| Gastroenterology, Internal Medicine | VA | |
| G A S T R O E N T E R O L O G Y | VA | |
| Gastroenterology, Internal Medicine | VA |
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