Physician Compare National (NPI:1366860397)

HEALTHCARE PROVIDER: BARRY KYU SIK GOLDENSON KANG MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1366860397
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901109065
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200402003562
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KANG
	Individual professional last name
Provider First Name	BARRY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BRONXCARE HEALTH SYSTEM
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3870404429
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	292
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1650 GRAND CONCOURSE
	Group Practice or individual's line 1 address
City	BRONX
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	104577606
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7189927669
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440161
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TRISTAR CENTENNIAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330009
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BRONX-LEBANON HOSPITAL CENTER - CONCOURSE DIVISION
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y