Individual provider Active NPI

Nathan Kwon

  • Emergency Medicine Physician
  • Tripler AMC, HI
National Provider Identifier
1295790368
Registry record updated Dec 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-13468 Issued in HI
Practice address
1 Jarrett White Rd
Tripler Army Medical Center Attn: MCHK-QS
Tripler AMC, HI 96859-5001
Phone
(808) 433-2460
Fax
(808) 433-1558
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-13468 HI Primary

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center Attn: MCHK-QS
Tripler AMC, HI 96859-5001

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Other practice location 1

86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 697-3152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20051007000408 HI Practitioner - Emergency Medicine 8123043205 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-13468HIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waianae District Comprehensive Health and Hospital Board, Inc CurrentSince Jan 8, 2020 Accepting new patients

Locations

86-260 Farrington Hwy
Waianae, HI 96792
Phone (808) 696-7081

Organizations & group practices 2

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702166400000",
    "number": "1295790368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86-260 Farrington Hwy",
            "address_purpose": "LOCATION",
            "city": "Waianae",
            "state": "HI",
            "postal_code": "967923128",
            "country_code": "US",
            "telephone_number": "808-697-3152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2023-12-10",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD-13468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tripler AMC, HI

Sources for this page

Verify at the official NPI Registry.