Individual provider Active NPI

James Taekyoon Kwan

  • Ophthalmology Physician
  • Boston, MA
National Provider Identifier
1093460677
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
24788 Issued in MA
Practice address
260 Tremont St
Boston, MA 02116-5603
Phone
(617) 636-4600
NPI assigned
Feb 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Ophthalmology Physician 207W00000X 24788 MA Primary

Addresses

Primary practice location

260 Tremont St
Boston, MA 02116-5603

Mailing address

260 Tremont St
Boston, MA 02116-5603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260608002997 MA Practitioner - Ophthalmology 7315418621

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Consultants of Boston IncGroup PAC ID 4789651498, shared by 4 NPIs, 68 clinicians

Practice addresses (Care Compare)

50 Staniford St
Suite 600
Boston, MA 02114-2539
Phone (617) 367-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24788MAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1644710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1093460677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165603",
            "telephone_number": "617-636-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAN",
        "first_name": "JAMES",
        "middle_name": "TAEKYOON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-13",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "24788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.