Jungho Lee Kwon, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301083389 Issued in MI

Practice address

2825 Livernois Rd
Troy, MI 48083-1214

Phone

(248) 689-7428

NPI assigned

May 21, 2007

Last updated

Jul 26, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Dermatology

Education

Un of California, Irvine, College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkwon16961@direct.hfhs.org
• Direct secure messaging: jungho.kwon.1@18430.direct.athenahealth.com

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.

• Henry Ford Health System

  • Dermatology Physician
  • Detroit, MI
  • NPI 1730252339
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD
• Henry Ford Maplegrove Center

  dba Henry Ford Health System

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1326257213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831214",
            "telephone_number": "248-689-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831214",
            "telephone_number": "248-689-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JUNGHO",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301083389",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N2611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Kutz, PA-C
• Anne Marie Kuzma, NP
• Dariya Kuzmenko
• Andrea Nicole Kwasky, DNP
• Jimmy Kwok, D.C.
• Luana J Kyselka, MD
• L.W Pest Control LLC
• Laboratory Corporation of America
• Danielle Lacanaria
• Danielle Lacy

• Dermatology Physician in Troy, MI
• Providers in Troy, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.