NPIMap

Individual provider Active NPI

Minyoung Kwak, M.D., M.P.H.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Rochester, NY
National Provider Identifier
1467879338
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
302715 Issued in NY
Practice address
1415 Portland Ave Ste 240
Rochester, NY 14621-3022
Phone
(585) 922-3260
NPI assigned
Mar 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 302715 NY Primary

Addresses

Primary practice location

1415 Portland Ave Ste 240
Rochester, NY 14621-3022

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (785) 298-8351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002001386 NY Practitioner - Thoracic Surgery 6901128495 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Tulane University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians
United Memorial Medical CenterGroup PAC ID 0547259376, 271 clinicians

Practice addresses (Care Compare)

1415 Portland Ave
Rochester, NY 14621-3038
Phone (585) 544-6550

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 429-2289

1561 Long Pond Rd
Suite 414
Rochester, NY 14626-4117
Phone (585) 723-7750

1565 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7366

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

16 Bank St
Batavia, NY 14020-2250
Phone (585) 344-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
302715NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Sep 9, 2024 Accepting new patients
Newark Wayne Community Hospital CurrentSince Sep 9, 2024 Accepting new patients
Rochester General Hospital CurrentSince Sep 9, 2024 Accepting new patients
Western New York Medical Practice P.C CurrentSince Sep 9, 2024 Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Sep 9, 2024 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
United Memorial Medical Center CurrentSince Sep 12, 2024 Accepting new patients
Newark Wayne Community Hospital CurrentSince Sep 9, 2024 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Sep 9, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Sep 9, 2024 Accepting new patients
United Memorial Medical Center Current Accepting new patients

Locations

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

1561 Long Pond Rd
Ste 408
Rochester, NY 14626
Phone (585) 442-4141

1415 Portland Ave
Rochester, NY 14621
Phone (585) 275-7741

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1415 Portland Ave
Ste 240
Rochester, NY 14621
Phone (585) 922-3260

Interoperability endpoints

  • Direct secure messaging: mkwak400318@direct.rochesterregional.org

Organizations & group practices 11

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 10

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1467879338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PORTLAND AVE STE 240",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213022",
            "telephone_number": "585-922-3260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "785-298-8351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWAK",
        "first_name": "MINYOUNG",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "302715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.