Individual provider Active NPI

Kuwong Bomwara Mwamukonda, M. D.

  • Urology Physician
  • Kettering, OH
National Provider Identifier
1689849192
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35.146670 Issued in OH
Practice address
3737 Southern Blvd Ste 4200
Kettering, OH 45429-0135
Phone
(937) 294-1489
Fax
(937) 294-7999
NPI assigned
Apr 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35.146670 OH Primary
Urology Physician 208800000X MD427202 PA

Addresses

Primary practice location

3737 Southern Blvd Ste 4200
Kettering, OH 45429-0135

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Other practice location 1

1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-7529

Other practice location 2

3551 Roger Brooke Dr
Urology Clinic, 2nd flr, BAMC
San Antonio, TX 78234
Phone (202) 782-6407

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230511000620 OH Practitioner - Urology 5395877849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Kentucky College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3737 Southern Blvd
Suite 4200
Kettering, OH 45429-0135
Phone (937) 294-1489

Hospital & facility affiliations

  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
  • Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD427202PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Feb 6, 2023 Accepting new patients
Alliance Physicians Inc Current Accepting new patients

Locations

3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3737 Southern Blvd
Ste 4200
Kettering, OH 45429
Phone (937) 813-7348

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

Interoperability endpoints

  • Direct secure messaging: kmwamukonda867820@direct.ketteringhealth.org

Organizations & group practices 2

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 5

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": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1689849192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD STE 4200",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454290135",
            "telephone_number": "937-294-1489",
            "fax_number": "937-294-7999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Wilford Hall Loop Bldg 4554",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-292-7529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_2": "Urology Clinic, 2nd flr, BAMC",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78234",
            "country_code": "US",
            "telephone_number": "202-782-6407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWAMUKONDA",
        "first_name": "KUWONG",
        "middle_name": "BOMWARA",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.146670",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD427202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.