Individual provider Active NPI

Kenneth Kieun Choi, MD

  • Urology Physician
  • Tucson, AZ
National Provider Identifier
1255333589
Registry record updated May 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
27206 Issued in AZ
Practice address
2260 W Orange Grove Rd
Tucson, AZ 85741-3117
Phone
(520) 795-5830
Fax
(520) 885-4469
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 27206 AZ
Urology Physician 208800000X 27206 AZ Primary

Addresses

Primary practice location

2260 W Orange Grove Rd
Tucson, AZ 85741-3117

Mailing address

6325 E Tanque Verde Rd
Tucson, AZ 85715-3808
Phone (520) 795-5830

Other identifiers 1

IdentifierTypeStateIssuer
472150MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100916001212 AZ Practitioner - Urology 9931113438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Arizona College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3140 N Swan Rd
Tucson, AZ 85712-1227
Phone (520) 245-7562

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27206AZMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choi Urology PLLC Urology CurrentSince Jul 3, 2019 Accepting new patients
Epoch - Southern Arizona Limited Liability Company PastSince Nov 7, 2014 Accepting new patients
Carondelet St Marys Campus LLC PastSince Apr 19, 2004 Accepting new patients

Locations

3140 N Swan Rd
Tucson, AZ 85712
Phone (520) 245-7562

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588377600000",
    "number": "1255333589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153808",
            "telephone_number": "520-795-5830",
            "fax_number": "520-885-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413117",
            "telephone_number": "520-795-5830",
            "fax_number": "520-885-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "KENNETH",
        "middle_name": "KIEUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "27206",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "27206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "472150",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.