Individual provider Active NPI

Lois Min Jee Kwon

  • Emergency Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1306415914
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
80458 Issued in CT
Practice address
2800 Main St
Bridgeport, CT 06606-4201
Phone
(475) 210-5604
NPI assigned
Jun 18, 2021
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 80458 CT Primary

Addresses

Primary practice location

2800 Main St
Bridgeport, CT 06606-4201

Mailing address

1290 Silas Deane Hwy
HHC-Cvo
Wethersfield, CT 06109-4337

Other practice location 1

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20250807004191 CT Practitioner - Emergency Medicine 8628576899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2800 Main St
Bridgeport, CT 06606-4201
Phone (203) 576-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Aug 1, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

263 Farmington Ave
#65
Farmington, CT 06030
Phone (860) 679-4988

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: lkwon2389617@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1306415914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "address_2": "HHC-CVO",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "475-210-5604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033031",
            "country_code": "US",
            "telephone_number": "404-616-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "LOIS",
        "middle_name": "MIN JEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2025-07-09",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "80458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.