Nicole Boon Jung Kwon, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A124134 Issued in CA

Practice address

34 Mark West Springs Road
Second Floor
Santa Rosa, CA 95403

Phone

(707) 541-7900

Fax

(707) 573-5413

NPI assigned

Apr 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Boon Jung Kwon Former name

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

Specialty

Obstetrics/Gynecology

Education

Rush Medical College of Rush University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkwon302729@hisp.ehr.sutterhealth.org
• Direct secure messaging: nkwon627544@direct.ochin.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1518345511
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769

  Obstetrics & Gynecology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1427349869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MARK WEST SPRINGS ROAD",
            "address_2": "SECOND FLOOR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-541-7900",
            "fax_number": "707-573-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MARK WEST SPRINGS ROAD",
            "address_2": "SECOND FLOOR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-541-7900",
            "fax_number": "707-573-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "NICOLE",
        "middle_name": "BOON JUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A124134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOON JUNG",
            "last_name": "KWON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kuziara Nutrition
• John Stanton Kuziara
• Anastasia Alva Kwa, RRT
• Evan Kwan, MD
• Jin Kwon, MD
• Jane Kwong
• Charlotte Kyle
• Kristen Huff Kyle
• L Reed Walker Jr MD Inc
• Danielle Carmen La Luz

• Obstetrics & Gynecology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.