Individual provider Active NPI

Ji Won Ahn, MD

  • MOHS-Micrographic Surgery Physician
  • Walnut Creek, CA
National Provider Identifier
1023460243
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
66941 Issued in MN
Practice address
320 Lennon LN Dept of
Walnut Creek, CA 94598-2419
Phone
(925) 817-5678
NPI assigned
Jul 12, 2016
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 66941 MN Primary

Addresses

Primary practice location

320 Lennon LN Dept of
Walnut Creek, CA 94598-2419

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210830002654 PA Practitioner - Dermatology 2466748579 Reassigns benefits to 1 organization
I20241029002314 CA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 2466748579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

320 Lennon LN
Walnut Creek, CA 94598-2419

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin cancer1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66941MNMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Oct 22, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince Oct 1, 2021 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 22, 2024 Accepting new patients
University of Pittsburgh Physicians Mohs-Micrographic Surgery CurrentSince Oct 1, 2021 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 Lennon Ln
Walnut Creek, CA 94598
Phone (925) 906-2000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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

3601 5th Ave
Ste 5A
Pittsburgh, PA 15213
Phone (412) 647-4200

3708 5th Ave
Ste 50068
Pittsburgh, PA 15213
Phone (412) 246-7021

Interoperability endpoints

  • Direct secure messaging: jahn357177@direct.hfhs.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1023460243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LENNON LN DEPT OF",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982419",
            "telephone_number": "925-817-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "JI WON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MN",
            "license": "66941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "320 Lennon Ln Dept Of",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945982419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.