Individual provider Active NPI

Young Jay Kwak, M.D.

  • Internal Medicine Physician
  • New Britain, CT
National Provider Identifier
1407182249
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
051419 Issued in CT
Practice address
300 Kensington Ave
New Britain, CT 06051
Phone
(860) 832-8150
Fax
(860) 224-6298
NPI assigned
Oct 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 051419 CT
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 051419 CT Primary

Addresses

Primary practice location

300 Kensington Ave
New Britain, CT 06051

Mailing address

2110 Silas Deane Hwy
Rocky Hill, CT 06067-2313
Phone (860) 832-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20130611000625 CT Practitioner - Internal Medicine 8921247529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northeastern Ohio University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians

Practice addresses (Care Compare)

100 Simsbury Rd
Avon, CT 06001-3793
Phone (860) 258-3480

1260 Silas Deane Hwy
Wethersfield, CT 06109-4362
Phone (860) 832-4666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

State licenses

LicenseStateTypeSpecialty
051419CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians PLLC CurrentSince Sep 1, 2017 Accepting new patients
Starling Physicians, PLLC Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

300 Kensington Ave
New Britain, CT 06051
Phone (860) 224-6200

2110 Silas Deane Hwy
Rocky Hill, CT 06067

Interoperability endpoints

  • Direct secure messaging: young.kwak@xdr.hhchealthdirect.org

Organizations & group practices 4

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 3

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": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1407182249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672313",
            "telephone_number": "860-832-8150",
            "fax_number": "860-224-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KENSINGTON AVE",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06051",
            "telephone_number": "860-832-8150",
            "fax_number": "860-224-6298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "YOUNG",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-29",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "051419",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "051419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.