Sung Kwong Or, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

34008241O Issued in OH

Practice address

1538 Marsetta Dr
Beavercreek, OH 45432-2733

Phone

(937) 427-2828

Fax

(937) 427-2880

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Ophthalmology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Trinity Eye Care,LLC

  • Ophthalmology Physician
  • Beavercreek, OH
  • NPI 1518925429

  OH, Ophthalmology

  Medicare reassignment NPD Authorized official
• Dayton Osteopathic Hospital

  • Multi-Specialty Clinic/Center
  • Dayton, OH
  • NPI 1588630347

  OH

  Medicare reassignment NPD
• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  NPD
• Dayton Osteopathic Hospital

  • Obstetrics & Gynecology Physician
  • Dayton, OH
  • NPI 1053386102
  NPD
• Dayton Osteopathic Hospital

  • Specialty Pharmacy
  • Kettering, OH
  • NPI 1629511688
  NPD
• Eye Care & Surgery Assoc., Inc.

  • Ophthalmology Physician
  • Sidney, OH
  • NPI 1992858450

  Ophthalmology

  NPD (past)
• JTDM Family Practice LLC

  • Family Medicine Physician
  • St Marys, OH
  • NPI 1184652539
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1477511475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 MARSETTA DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322733",
            "telephone_number": "937-427-2828",
            "fax_number": "937-427-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 MARSETTA DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322733",
            "telephone_number": "937-427-2828",
            "fax_number": "937-427-2880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454054536",
            "country_code": "US",
            "telephone_number": "937-723-4994",
            "fax_number": "937-463-4244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OR",
        "first_name": "SUNG",
        "middle_name": "KWONG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "34008241O",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000384230",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE",
            "identifier": "510552661027",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2492324",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sor185317@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "330 Forest Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454054536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "330 Forest Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454054536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adelaide Omane, CRNA
• Natosha Smith Onasanya, MD, MPH
• Onda Counseling Services, LLC
• Brian W Ondulick, DO
• Optical Fashion Centers Inc
• Orthopedic Associates of S W Ohio, Inc
• Orthopedic Associates of S W Ohio, Inc
• Wanda Socorro Ortiz Thayne, LCSW
• Jerika Ortlieb, MD
• Michelle A Ortman, P.A.-C

• All providers in Beavercreek, OH
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.