Individual provider Active NPI

Jane Jeehyun Kwon, MD

  • Pediatrics Physician
  • New Haven, CT
National Provider Identifier
1003435488
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
79290 Issued in CT
Practice address
55 Lock St
New Haven, CT 06511-3603
Phone
(203) 432-0206
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 79290 CT Primary

Addresses

Primary practice location

55 Lock St
New Haven, CT 06511-3603

Mailing address

55 Lock St
New Haven, CT 06511-3603
Phone (203) 432-0076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718002039 PA Practitioner - Pediatric Medicine 0345662615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
79290CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2023 Accepting new patients
University of Pittsburgh Physicians Pediatrics CurrentSince Jul 1, 2023 Accepting new patients
Optimus Health Care Inc Past Accepting new patients

Locations

3600 Forbes Ave
Ste 140
Pittsburgh, PA 15213

3420 5th Ave
Pittsburgh, PA 15213
Phone (412) 692-5285

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

275 Clairton Blvd
West Mifflin, PA 15236
Phone (412) 650-2375

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1003435488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LOCK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113603",
            "telephone_number": "203-432-0076",
            "fax_number": "203-432-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LOCK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113603",
            "telephone_number": "203-432-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JANE",
        "middle_name": "JEEHYUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "79290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.