Individual provider Active NPI

Matthew Kwong

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Oakland, CA
National Provider Identifier
1417318320
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
A153027 Issued in CA
Practice address
212 9TH St Ste 205
Oakland, CA 94607-4478
Phone
(510) 268-1118
NPI assigned
Mar 19, 2016
Last updated
Jul 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X A153027 CA Primary

Addresses

Primary practice location

212 9TH St Ste 205
Oakland, CA 94607-4478

Mailing address

212 9TH St Ste 205
Oakland, CA 94607-4478
Phone (510) 268-1118

Other practice location 1

212 9th St Ste 205
Oakland, CA 94607-4478
Phone (510) 268-1118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180802003431 CA Practitioner - General PracticePractitioner - Hospice/Palliative Care 0345503751 Practice locations: Berkeley, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Network Pacific Home Care, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matthew.kwong.1@17632.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1417318320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 9TH ST STE 205",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074478",
            "telephone_number": "510-268-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 9TH ST STE 205",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074478",
            "telephone_number": "510-268-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 9th St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946074478",
            "country_code": "US",
            "telephone_number": "510-268-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWONG",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-19",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A153027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.