Individual provider Active NPI

Ryan H Kwon, D.O.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1235239153
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
248607 Issued in NY
Practice address
380 2ND Ave
New York, NY 10010-5615
Phone
(212) 375-1065
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 248607 NY Primary

Addresses

Primary practice location

380 2ND Ave
New York, NY 10010-5615

Mailing address

PO Box 5024
New York, NY 10087-5024
Phone (800) 627-4470

Other practice location 1

2510 30th Ave
Astoria, NY 11102-2448
Phone (800) 627-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080829000083 NY Practitioner - Anesthesiology 7719987874 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248607NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
York Anesthesiologists PLLC Anesthesiology CurrentSince Apr 1, 2021 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients
University Physicians of Brooklyn, Inc Anesthesiology Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

380 2nd Ave
New York, NY 10010
Phone (212) 253-6600

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1235239153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5024",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100875024",
            "telephone_number": "800-627-4470",
            "fax_number": "412-937-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105615",
            "telephone_number": "212-375-1065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111022448",
            "country_code": "US",
            "telephone_number": "800-627-4470",
            "fax_number": "412-937-5710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "RYAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "248607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.