Individual provider Active NPI

Kelvin Ming-Tak Kwong, M.D.

  • Pediatric Otolaryngology Physician
  • New Brunswick, NJ
National Provider Identifier
1184820201
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
25MA09318800 Issued in NJ
Practice address
10 Plum St
8TH Floor
New Brunswick, NJ 08901-2065
Phone
(732) 235-5530
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA09318800 NJ
Pediatric Otolaryngology Physician 207YP0228X 25MA09318800 NJ Primary

Addresses

Primary practice location

10 Plum St
8TH Floor
New Brunswick, NJ 08901-2065

Mailing address

10 Plum St FL 8
New Brunswick, NJ 08901-2066
Phone (732) 235-5530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20130912000538 NJ Practitioner - Emergency Medicine 3476797465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutgers Health-RWJ Neurosurgery FacultyGroup PAC ID 4587613443, 189 clinicians

Practice addresses (Care Compare)

10 Plum St
New Brunswick, NJ 08901-2065
Phone (732) 235-5590

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09318800NJMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Current Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Aug 1, 2013 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Feb 1, 2021 Accepting new patients

Locations

10 Plum St
Fl 5
New Brunswick, NJ 08901
Phone (732) 235-5530

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

10 Plum St
New Brunswick, NJ 08901
Phone (732) 235-6333

10 Plum St
Fl 8
New Brunswick, NJ 08901
Phone (732) 235-5530

Interoperability endpoints

  • Direct secure messaging: kkwong17329@epicdirect.rwjbh.org

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1184820201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PLUM ST FL 8",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012066",
            "telephone_number": "732-235-5530",
            "fax_number": "732-235-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PLUM ST",
            "address_2": "8TH FLOOR",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012065",
            "telephone_number": "732-235-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "KELVIN",
        "middle_name": "MING-TAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA09318800",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NJ",
            "license": "25MA09318800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.