Roy Pillsub Won, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

A134883 Issued in CA

Practice address

1950 Sunny Crest Dr Ste 3500
Fullerton, CA 92835-3646

Phone

(714) 408-4249

Fax

(714) 525-0123

NPI assigned

Jul 17, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in CA, TX, MD, DC, VA5 enrollments

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 5

Specialty

General PracticeAlso: Colorectal Surgery (Proctology)

Education

University of Cincinnati College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: rwon336663@directhoustonmethodist.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • MC Lean, VA
  • NPI 1073678637

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Woodbridge, VA
  • NPI 1114677572
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Largo, MD
  • NPI 1366781700

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Timonium, MD
  • NPI 1457023616
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Gaithersburg, MD
  • NPI 1497023188

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Kensington, MD
  • NPI 1578638425

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Halethorpe, MD
  • NPI 1942546486
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment NPD
• Kelsey-Seybold Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Colon & Rectal Surgery

  Medicare reassignment NPD

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

• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1225470354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 3500",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353646",
            "telephone_number": "714-408-4249",
            "fax_number": "714-525-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 3500",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353646",
            "telephone_number": "714-408-4249",
            "fax_number": "714-525-0123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Vision Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773843000",
            "country_code": "US",
            "telephone_number": "713-442-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770141487",
            "country_code": "US",
            "telephone_number": "713-442-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WON",
        "first_name": "ROY",
        "middle_name": "PILLSUB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-17",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "S6980",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A134883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415263901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415263903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415263902",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwon33956@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770141487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770141487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwon33956@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "106 Vision Park Blvd",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773843000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "106 Vision Park Blvd",
            "city": "Shenandoah",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773843000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "15655 Cypress Wood Medical Dr Ste 100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770141487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elexus Denise Womack
• Women'S Transitional Living Center
• Won Bo Park DDS Apc
• Christine Hae-Jin Won, M.D.
• Pamela Won, M.S., CCC-SLP
• Amanda Wong, PHARM.D.
• Carly Wong, OTR/L
• Cassidy Wong
• Jeremy Wong
• Katrina Wong

• Colon & Rectal Surgery Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.