Individual provider Active NPI

Ronald C. Kwon, M.D.

  • Internal Medicine Physician
  • Makawao, HI
National Provider Identifier
1215083191
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-5040 Issued in HI
Practice address
55 Pukalani St
Makawao, HI 96768-8544
Phone
(808) 242-6464
Fax
(808) 984-7453
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39210 MA
Internal Medicine Physician 207R00000X MD-5040 HI Primary

Addresses

Primary practice location

55 Pukalani St
Makawao, HI 96768-8544

Mailing address

2180 Main St
Wailuku, HI 96793-1625
Phone (808) 242-6464

Other practice location 1

86 Baker Avenue Ext
Concord, MA 01742-2132
Phone (978) 287-9310

Other identifiers 1

IdentifierTypeStateIssuer
2149206MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20051122000471 HI Practitioner - Internal Medicine 6305865189 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Colorado School of Medicine, Denver, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maui Medical Group IncGroup PAC ID 7214823368, 68 clinicians

Practice addresses (Care Compare)

55 Pukalani St
Makawao, HI 96768-8544
Phone (808) 573-6200

Hospital & facility affiliations

  • Bayada Home Health Care Home health agency, Wailuku, HI, CCN 127309

National Provider Directory

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

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Maui Medical Group Inc Internal Medicine CurrentSince Feb 3, 2025 Accepting new patients
Windward Heart Center LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

25 Maluniu Ave
Ste 201
Kailua, HI 96734
Phone (808) 261-2441

55 Pukalani St
Makawao, HI 96768
Phone (808) 572-8266

30 Kupaoa St
Ste 205
Makawao, HI 96768
Phone (808) 263-5009

2180 Main St
Wailuku, HI 96793
Phone (808) 242-4267

Networks

  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1215083191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931625",
            "telephone_number": "808-242-6464",
            "fax_number": "808-984-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PUKALANI ST",
            "city": "MAKAWAO",
            "state": "HI",
            "postal_code": "967688544",
            "telephone_number": "808-242-6464",
            "fax_number": "808-984-7453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 Baker Avenue Ext",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "MA",
            "postal_code": "017422132",
            "country_code": "US",
            "telephone_number": "978-287-9310",
            "fax_number": "978-287-9357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "RONALD",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "39210",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-5040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2149206",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Makawao, HI

Sources for this page

Verify at the official NPI Registry.