Pearl Chu Kwong, MD PHD

Primary specialty

Pediatric Dermatology PhysicianTaxonomy code 207NP0225X

License

ME 82288 Issued in FL

Practice address

10175 Fortune Pkwy Unit 1203
Jacksonville, FL 32256-6758

Phone

(904) 519-5292

Fax

(904) 519-5296

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Dermatology

Education

University of Alberta, Faculty of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Suncoast Skin Solutions

  • Dermatology Physician
  • Lutz, FL
  • NPI 1487827416
  Medicare reassignment Care Compare group NPD
• Douglas K Pierce MD PA

  • Procedural Dermatology Physician
  • Largo, FL
  • NPI 1053515379
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1043309909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY",
            "address_2": "SUITE 1203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563519",
            "telephone_number": "904-519-5292",
            "fax_number": "904-519-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 1203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566758",
            "telephone_number": "904-519-5292",
            "fax_number": "904-519-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "PEARL",
        "middle_name": "CHU",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME82288",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME 82288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hye Yun Kwag, PA
• Alexandria Jean Kwan, MT-BC
• Dyman Christian Kwarciak, MD
• Sabrina Kwok, NP
• Minkyung Kwon, MD
• Wai P Kyaw, MBBS, MD
• Carl Walter Kyle, LMHC
• Michael Gardner Kynn, OD
• Oleksiy Kyrychenko, DO
• L & S Support Services

• Pediatric Dermatology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.