NPIMap

Individual provider Active NPI

Kunyong Xu, MD

  • Retina Specialist (Ophthalmology) Physician
  • Phoenix, AZ
National Provider Identifier
1356877781
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
58778 Issued in AZ
Practice address
1750 E Glendale Ave
Phoenix, AZ 85020-4328
Phone
(602) 242-4928
NPI assigned
May 4, 2017
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 287677 NY
Retina Specialist (Ophthalmology) Physician 207WX0107X 58778 AZ Primary

Addresses

Primary practice location

1750 E Glendale Ave
Phoenix, AZ 85020-4328

Mailing address

1750 E Glendale Ave
Phoenix, AZ 85020-4328
Phone (602) 242-4928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AZ, SC, GA4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20180102001398 NY Practitioner - Ophthalmology 2365700069 Reassigns benefits to 1 organization
I20190912000164 AZ Practitioner - Ophthalmology 2365700069 Reassigns benefits to 2 organizations
I20210121001796 SC Practitioner - Ophthalmology 2365700069 Reassigns benefits to 1 organization
I20210126001466 GA Practitioner - Ophthalmology 2365700069 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
McMaster Un, Michael Degroote School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

1750 E Glendale Ave
Phoenix, AZ 85020-5505
Phone (602) 242-4928

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58778AZMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc Single Specialty CurrentSince Apr 1, 2021 Accepting new patients
District Medical Group, Inc CurrentSince Sep 13, 2024 Accepting new patients
Weill Medical College of Cornell Single Specialty CurrentSince Nov 20, 2017 Accepting new patients
Associated Retina Consultants, LTD. Single Specialty CurrentSince Mar 1, 2024 Accepting new patients
NPI 1306722244 CurrentSince Aug 17, 2025 Accepting new patients
District Medical Group, Inc Single Specialty Current Accepting new patients
District Medical Group, Inc CurrentSince Sep 13, 2024 Accepting new patients
Weill Medical College of Cornell Single Specialty CurrentSince Nov 20, 2017 Accepting new patients
Southeast Retina Center PC Single Specialty CurrentSince Feb 1, 2021 Accepting new patients
Au Medical Associates Inc Single Specialty CurrentSince Apr 1, 2021 Accepting new patients
Associated Retina Consultants, LTD. Single Specialty Past Accepting new patients

Locations

1626 N Litchfield Rd
Ste 50
Goodyear, AZ 85395

302 W Main St
Payson, AZ 85541
Phone (928) 474-4126

1750 E Glendale Ave
Phoenix, AZ 85020
Phone (602) 216-1144

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

650 Oglethorpe Ave
Ste 2
Athens, GA 30606
Phone (706) 268-9868

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

3685 Wheeler Rd
Ste 201
Augusta, GA 30909
Phone (706) 650-0061

3685 Wheeler Rd
Ste 202
Augusta, GA 30909
Phone (423) 892-9483

1000 Cowles Clinic Way
Ste E-100
Greensboro, GA 30642
Phone (478) 412-2880

6061 Lake Oconee Pkwy
Greensboro, GA 30642
Phone (706) 453-4535

12877 Jones St
Ste A
Lavonia, GA 30553
Phone (706) 356-0575

111 Fieldstone Dr
Ste 100
Milledgeville, GA 31061
Phone (478) 453-9333

214 Savannah Ave
Statesboro, GA 30458
Phone (912) 764-5609

311 Fluker St
Thomson, GA 30824
Phone (404) 595-3153

23 East Sq
Washington, GA 30673
Phone (706) 678-3926

1305 York Ave
Fl 11
New York, NY 10021
Phone (646) 962-2020

1305 York Ave
Ste 11
New York, NY 10021
Phone (646) 962-2020

410 University Pkwy
Ste 1500A
Aiken, SC 29801
Phone (803) 262-5020

Interoperability endpoints

  • Direct secure messaging: kunyong.xu.p4@direct.clemsoneye.nextgenshare.com
  • Direct secure messaging: kxu268318@direct.valleywisehealth.org

Organizations & group practices 10

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 12

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": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1356877781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 E GLENDALE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204328",
            "telephone_number": "602-242-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E GLENDALE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204328",
            "telephone_number": "602-242-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "KUNYONG",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "287677",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AZ",
            "license": "58778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.