Individual provider Active NPI

Albert O Kwon, MD

  • Colon & Rectal Surgery Physician
  • Ridgewood, NJ
National Provider Identifier
1225298722
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
25MA08887800 Issued in NJ
Practice address
1124 E Ridgewood Ave Ste 202
Ridgewood, NJ 07450-3941
Phone
(201) 689-9100
Fax
(201) 689-9108
NPI assigned
Jun 10, 2008
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 25MA08887800 NJ Primary

Addresses

Primary practice location

1124 E Ridgewood Ave Ste 202
Ridgewood, NJ 07450-3941

Mailing address

1124 E Ridgewood Ave Ste 202
Ridgewood, NJ 07450-3941
Phone (201) 689-9100

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
I20110616000490 NJ Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 4082892286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Warren Alpert Medical School of Brown University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

1 Valley Health PLZ
Suite 1
Paramus, NJ 07652-3628
Phone (201) 634-5300

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy154
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Oct 1, 2018 Accepting new patients
Sovereign Medical Group LLC Colon & Rectal Surgery CurrentSince Sep 1, 2013 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Sep 1, 2013 Accepting new patients

Locations

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

140 E Ridgewood Ave
Ste 525S
Paramus, NJ 07652

1124 E Ridgewood Ave
Ste 202
Ridgewood, NJ 07450
Phone (201) 689-9400

140 Chestnut St
Ste 301
Ridgewood, NJ 07450
Phone (201) 447-2777

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: albert.kwon.1@5622.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1225298722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E RIDGEWOOD AVE STE 202",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503941",
            "telephone_number": "201-689-9100",
            "fax_number": "201-689-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E RIDGEWOOD AVE STE 202",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503941",
            "telephone_number": "201-689-9100",
            "fax_number": "201-689-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "ALBERT",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "25MA08887800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.