Individual provider Active NPI

Kuong Ngann, DO

  • Trauma Surgery Physician
  • Fort Defiance, AZ
National Provider Identifier
1376839167
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
20A12099 Issued in CA
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649
Phone
(928) 729-8000
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5482 TN
Trauma Surgery Physician 2086S0127X 20A12099 CA Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TN, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140408000708 CA Practitioner - General Surgery 9830321728 Reassigns benefits to 6 organizations
I20231218000783 TN Practitioner - General Surgery 9830321728 Reassigns benefits to 1 organization
I20260521001589 TX Practitioner - General Surgery 9830321728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Trauma Surgeons IncGroup PAC ID 0547366106, 36 clinicians
Pajaro Valley Health Care DistrictGroup PAC ID 6002292497, 15 clinicians
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

65 Nielson St
Suite 125
Watsonville, CA 95076-2491
Phone (831) 768-6266

751 S Bascom Ave
Santa Clara Vly Med
San Jose, CA 95128-2604
Phone (408) 885-5000

Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082

PO Box
Suite 649
Fort Defiance, AZ 86504-0649

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
97.68
Improvement activities
40
Cost
62.65

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12099CAMDTrauma Surgery Physician
5482TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Surgery CurrentSince Aug 1, 2017 Accepting new patients
KND Development 59 LLC Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Feb 1, 2020 Accepting new patients
KND Development 59 LLC CurrentSince Dec 12, 2017 Accepting new patients
Kern County Hospital Authority CurrentSince Jun 12, 2018 Accepting new patients
Pajaro Valley Health Care District Surgery CurrentSince Jun 3, 2025 Accepting new patients
County of Santa Clara CurrentSince Feb 1, 2020 Accepting new patients
Ut Methodist Physicians LLC Surgery CurrentSince Feb 9, 2024 Accepting new patients
KND Development 59, LLC CurrentSince Dec 12, 2017 Accepting new patients
Regents of the University of California CurrentSince Aug 1, 2017 Accepting new patients
Kern County Hospital Authority CurrentSince Jun 12, 2018 Accepting new patients
Desert Trauma Surgeons, Inc. Trauma Surgery CurrentSince Jan 1, 2024 Accepting new patients
Ut Medical Group Inc Surgery Past Accepting new patients

Locations

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

1180 N Indian Canyon Dr
Ste E317
Palm Springs, CA 92262
Phone (760) 416-5023

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

200 W Arbor Dr
#8896
San Diego, CA 92103
Phone (619) 543-7200

4940 El Cajon Blvd
San Diego, CA 92115
Phone (619) 543-4500

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

65 Nielson St
Ste 125
Watsonville, CA 95076
Phone (831) 768-6266

4240 Bethel Rd
Ste 200
Olive Branch, MS 38654
Phone (901) 758-7970

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

1325 Eastmoreland Ave
Ste 370
Memphis, TN 38104
Phone (901) 516-8785

1325 Eastmoreland Ave
Ste 310
Memphis, TN 38104
Phone (901) 272-6010

Interoperability endpoints

  • Direct secure messaging: kngann140108@santaclaravalley.direct-ci.net

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 4

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1376839167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGANN",
        "first_name": "KUONG",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "5482",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "20A12099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

Verify at the official NPI Registry.