Edward Djan-Kwansa, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

256765 Issued in NY

Practice address

2228 Boller Ave
2ND Floor
Bronx, NY 10475-5502

Phone

(347) 668-0076

NPI assigned

Apr 21, 2010

Last updated

Apr 21, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1518284157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 BOLLER AVE",
            "address_2": "2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104755502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 BOLLER AVE",
            "address_2": "2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104755502",
            "telephone_number": "347-668-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJAN-KWANSA",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "256765",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "256765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany L Dixon, REGISTERED NURSE
• Ximena Diz
• Gideon John Dizon, RPT
• Josef Olivier Dizon, DPT
• Maricar B Dizon
• Marko Djapic, DMD
• DJM Physical Therapy, PC
• Olivia Djokoto, RN
• Janelle A Djomoah, RN
• Ann Gertrude Djuidje

• Family Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.