Individual provider Active NPI

In Kwang Yoon, MD

  • Physical Medicine & Rehabilitation Physician
  • Dearborn, MI
National Provider Identifier
1598735987
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301035560 Issued in MI
Practice address
17000 Hubbard Dr
Suite 800
Dearborn, MI 48126-4258
Phone
(313) 240-7595
Fax
(313) 240-7599
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301035560 MI Primary

Addresses

Primary practice location

17000 Hubbard Dr
Suite 800
Dearborn, MI 48126-4258

Mailing address

17000 Hubbard Dr
Suite 800
Dearborn, MI 48126-4258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20040416000086 MI Practitioner - Physical Medicine and Rehabilitation 3870588205 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301035560MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Sep 14, 2018 Accepting new patients
Southfield Rehabilitation Company CurrentSince Feb 1, 2023 Accepting new patients
Southfield Rehabilitation Company Physical Medicine & Rehabilitation CurrentSince Feb 1, 2023 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

11012 E 13 Mile Rd
Ste 111
Warren, MI 48093
Phone (586) 558-8470

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1598735987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 HUBBARD DR",
            "address_2": "SUITE 800",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 HUBBARD DR",
            "address_2": "SUITE 800",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264258",
            "telephone_number": "313-240-7595",
            "fax_number": "313-240-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "IN",
        "middle_name": "KWANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301035560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.