Individual provider Active NPI

Ohmin Kwon, MD

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
National Provider Identifier
1316409246
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
67157 Issued in AZ
Practice address
5652 E Baseline Rd
Mesa, AZ 85206-4713
Phone
(310) 970-4481
Fax
(948) 356-8192
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 67157 AZ Primary

Addresses

Primary practice location

5652 E Baseline Rd
Mesa, AZ 85206-4713

Mailing address

600 North Wolfe St
Phipps 160
Baltimore, MD 21287
Phone (410) 502-2447

Other practice location 1

600 North Wolfe St
Phipps 160
Baltimore, MD 21287
Phone (410) 502-2447

Other practice location 2

101 The City Dr S Ste 400
Orange, CA 92868-3201
Phone (714) 456-5691

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
I20230807003065 AZ Practitioner - Physical Medicine and Rehabilitation 5496171795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5652 E Baseline Rd
Mesa, AZ 85206-4713
Phone (310) 970-4481

Hospital & facility affiliations

  • Encompass Health Rehabilitation Hospital of East V Inpatient rehabilitation facility, Mesa, AZ, CCN 033037

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67157AZMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohmin Kwon MD PLLC Physical Medicine & Rehabilitation CurrentSince Jun 14, 2023 Accepting new patients
The Regents of the University of California-Irvine Past Accepting new patients

Locations

5652 E Baseline Rd
Mesa, AZ 85206
Phone (480) 477-7112

1675 E Villa St
Phoenix, AZ 85006
Phone (480) 801-6700

24 W Camelback Rd
Ste A330
Phoenix, AZ 85013

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.

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1316409246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NORTH WOLFE ST",
            "address_2": "PHIPPS 160",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21287",
            "telephone_number": "410-502-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5652 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064713",
            "telephone_number": "310-970-4481",
            "fax_number": "948-356-8192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 North Wolfe St",
            "address_2": "Phipps 160",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21287",
            "country_code": "US",
            "telephone_number": "410-502-2447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 The City Dr S Ste 400",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-5691",
            "fax_number": "714-456-8874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "OHMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "67157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.