Individual provider Active NPI

Ik-Sung Kwon, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Warsaw, NY
National Provider Identifier
1366468035
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
216936 Issued in NY
Practice address
2469 State Route 19 N
Warsaw, NY 14569-9336
Phone
(585) 786-2288
Fax
(585) 786-5371
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 216936 NY Primary

Addresses

Primary practice location

2469 State Route 19 N
Warsaw, NY 14569-9336

Mailing address

2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090708000606 NY Practitioner - Ophthalmology 9133103005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ponce School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Eye Specialists, P.C.Group PAC ID 1658384342, 3 clinicians

Practice addresses (Care Compare)

217 Summit St
Batavia, NY 14020-1613
Phone (585) 345-1342

2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-2288

355 Main St
Dansville, NY 14437-9798
Phone (585) 335-6045

Hospital & facility affiliations

  • Nicholas H Noyes Memorial Hospital Hospital, Dansville, NY, CCN 330238
  • Wyoming County Hospital, Warsaw, NY, CCN 331323

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.6
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn P Hoot MD PHD PS Inc PastSince Aug 1, 2010 Accepting new patients
Retina & Macula Specialists PS Past Accepting new patients
Retina and Macula Specialists PS Past Accepting new patients
Ues Optical, Inc PastSince Oct 14, 2014 Accepting new patients

Organizations & group practices 5

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 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1366468035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-2288",
            "fax_number": "585-786-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2469 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-2288",
            "fax_number": "585-786-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "IK-SUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NY",
            "license": "216936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

Verify at the official NPI Registry.