Yong Min Kwon, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA09117700 Issued in NJ

Practice address

123 Highland Ave
Glen Ridge, NJ 07028-1527

Phone

(973) 429-8800

Fax

(973) 748-7076

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

GastroenterologyAlso: Internal Medicine

Education

Birmingham Medical College, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ykwon198157@ahs.direct-ci.com
• Direct secure messaging: yong.kwon.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Internal Medicine

  NPD (past)

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

• Montclair Hospital LLC

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1528186384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "973-429-8800",
            "fax_number": "973-748-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "YONG",
        "middle_name": "MIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301085780",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301085780",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA09117700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sung T. Kim, M.D.
• Dusan Knezevic, MD
• Brian Koch
• Randy Kolodny, PT, DPT
• Ksa Medical LLC
• Robert Labruzza, D.C.
• Jill D Langell, OTR/L
• Lauren Lawson
• Robert Levai, MD
• Sangjin Lim, D.O.

• Gastroenterology Physician in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.