Individual provider Active NPI

Kyewon Ahn

  • Acupuncturist
  • Englewood Cliffs, NJ
National Provider Identifier
1215251582
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00069100 Issued in NJ
Practice address
701 E Palisade Ave
Suite 201
Englewood Cliffs, NJ 07632-3055
Phone
(201) 408-5700
NPI assigned
Mar 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00069100 NJ Primary

Addresses

Primary practice location

701 E Palisade Ave
Suite 201
Englewood Cliffs, NJ 07632-3055

Mailing address

720 E Palisade Ave Ste 106
Englewood Cliffs, NJ 07632-3054
Phone (201) 408-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MZ00069100NJMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Acupuncture PC Acupuncturist Past Accepting new patients
Queen Herb Acupuncture PC Acupuncturist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1215251582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E PALISADE AVE STE 106",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323054",
            "telephone_number": "201-408-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E PALISADE AVE",
            "address_2": "SUITE 201",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323055",
            "telephone_number": "201-408-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "KYEWON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-16",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00069100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.