NPIMap

Individual provider Active NPI

Christopher C Kwon, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Waco, TX
National Provider Identifier
1225074867
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
R6223 Issued in TX
Practice address
100 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone
(254) 202-2000
NPI assigned
Jun 21, 2006
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME133782 FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 32875 AZ
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X R6223 TX Primary

Addresses

Primary practice location

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other practice location 1

2435 W. Belvedere Ave
Suite 35
Balto., MD 21215-5224
Phone (410) 601-0900

Other practice location 2

1350 Hickory St Ste 102
Melbourne, FL 32901-3224
Phone (321) 434-3455

Other practice location 3

6006 49th St N Ste 310
Saint Petersburg, FL 33709
Phone (727) 527-9779

Other identifiers 3

IdentifierTypeStateIssuer
100793000MedicaidFL
866014MedicaidAZ
NE923OtherFLMEDICARE HF

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckwon781498@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040629000239 AZ Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 0143206235 Reassigns benefits to 2 organizations
I20211130000733 HI Practitioner - Thoracic Surgery 0143206235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HRMC, LLCGroup PAC ID 3072641265, 33 clinicians

Practice addresses (Care Compare)

101 Civic Ctr LN
Lake Havasu City, AZ 86403-5607
Phone (928) 453-3761

1741 Mesquite Ave
Suite 200a
Lake Havasu City, AZ 86403-5689
Phone (928) 550-4134

1851 Mesquite Ave
Lake Havasu City, AZ 86403-5680

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)59
Leg revascularization (restoring blood flow)12
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R6223TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HRMC, LLC Multi-Specialty Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Multi-Specialty Current Accepting new patients
Maui Heart & Lung, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Jan 1, 2022 Accepting new patients
Honorhealth Ambulatory Multi-Specialty Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients
Scottsdale Healthcare Corporation CurrentSince Feb 14, 2022 Accepting new patients
HRMC, LLC Multi-Specialty CurrentSince Jan 15, 2022 Accepting new patients
Honorhealth Ambulatory Multi-Specialty CurrentSince Feb 14, 2022 Accepting new patients
HRMC, LLC Multi-Specialty CurrentSince Jan 15, 2022 Accepting new patients
HRMC, LLC Multi-Specialty Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Havasu Regional Medical Center LLC Past Accepting new patients
Cardiology Consultants Multi-Specialty PastSince Sep 16, 2018 Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1741 Mesquite Ave
Ste 200A
Lk Havasu Cty, AZ 86403
Phone (928) 733-6020

1851 Mesquite Ave
Ste 116
Lk Havasu Cty, AZ 86403
Phone (928) 453-0890

1851 Mesquite Ave
Ste 202
Lk Havasu Cty, AZ 86403
Phone (928) 854-0094

2500 W Utopia Rd
Ste Cvo
Phoenix, AZ 85027

10210 N 92nd St
Ste 300
Scottsdale, AZ 85258
Phone (480) 882-7750

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

1849 Wili Pa Loop
Wailuku, HI 96793
Phone (808) 242-2010

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

85 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 442-5700

Interoperability endpoints

  • Direct secure messaging: christopher.kwon.1@19231.direct.athenahealth.com
  • Direct secure messaging: ckwon781498@direct.sw.org
  • FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 6

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1225074867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST MEDICAL BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128897",
            "telephone_number": "254-202-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2435 W. Belvedere Ave",
            "address_2": "Suite 35",
            "address_purpose": "LOCATION",
            "city": "Balto.",
            "state": "MD",
            "postal_code": "212155224",
            "country_code": "US",
            "telephone_number": "410-601-0900",
            "fax_number": "410-601-0901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Hickory St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-3455",
            "fax_number": "321-434-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6006 49th St N Ste 310",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "33709",
            "country_code": "US",
            "telephone_number": "727-527-9779",
            "fax_number": "727-522-0415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME133782",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AZ",
            "license": "32875",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "R6223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100793000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "866014",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "NE923",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckwon781498@direct.sw.org",
            "affiliation": "N",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.