Individual provider Active NPI

John M Kwon, PT, DPT, OCS

  • Orthopedic Physical Therapist
  • Fountain Valley, CA
National Provider Identifier
1104988708
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
25614 Issued in CA
Practice address
10900 Warner Ave Ste 111
Fountain Valley, CA 92708-3846
Phone
(714) 964-3337
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 25614 CA Primary

Addresses

Primary practice location

10900 Warner Ave Ste 111
Fountain Valley, CA 92708-3846

Mailing address

11 Alisal CT
Aliso Viejo, CA 92656-1850
Phone (949) 215-1566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000583 CA Practitioner - Physical Therapist in Private Practice 3072648765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Performance Physical Therapy, Inc.Group PAC ID 7810163573, 14 clinicians
Smart Health and WellnessGroup PAC ID 0749642585, 9 clinicians

Practice addresses (Care Compare)

15 Corporate Plaza Dr
Suite 130
Newport Beach, CA 92660-7940
Phone (949) 759-1840

27372 Aliso Creek Rd
Suite 200
Aliso Viejo, CA 92656-5339
Phone (949) 520-1012

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
72.95
Promoting interoperability
90
Improvement activities
40
Cost
68.29

Merit-based Incentive Payment System (MIPS)

Final score
33.34 of 100Reported as individual
Quality
20
Improvement activities
0
Cost
84.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Health & Wellness CurrentSince Jul 31, 2023 Accepting new patients
Core Performance Physical Therapy, Inc. Orthopedic CurrentSince Sep 1, 2011 Accepting new patients
Smart Health & Wellness CurrentSince Jul 31, 2023 Accepting new patients
California Therapy Solutions Orthopedic Past Accepting new patients

Locations

27372 Aliso Creek Rd
#200
Aliso Viejo, CA 92656
Phone (949) 520-1012

27372 Aliso Creek Rd
Ste 110
Aliso Viejo, CA 92656
Phone (949) 520-1014

27372 Aliso Creek Rd
Ste 200
Aliso Viejo, CA 92656
Phone (949) 520-1012

33 Creek Rd
Ste 190
Irvine, CA 92604
Phone (949) 262-3031

15 Corporate Plaza Dr
Ste 130
Newport Beach, CA 92660
Phone (949) 759-1840

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1104988708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ALISAL CT",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561850",
            "telephone_number": "949-215-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 WARNER AVE STE 111",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083846",
            "telephone_number": "714-964-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "25614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.