Individual provider Active NPI

Cedric Sekyong Kwon, M.D.

  • Anesthesiology Physician
  • Lompoc, CA
National Provider Identifier
1700931896
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A70537 Issued in CA
Practice address
508 E Hickory Ave
Lompoc, CA 93436-7337
Phone
(805) 737-3300
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 101932875 WI
Anesthesiology Physician 207L00000X A70537 CA Primary

Addresses

Primary practice location

508 E Hickory Ave
Lompoc, CA 93436-7337

Mailing address

136 N 3Rd St
Lompoc, CA 93436-7002
Phone (805) 736-3164

Other identifiers 1

IdentifierTypeStateIssuer
GR0058550MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120307000666 CA Practitioner - Anesthesiology 8022093210 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lompoc Valley Anesthesia AssociatesGroup PAC ID 4981689163, 11 clinicians
Oak Creek Anesthesia Services IncGroup PAC ID 9739509407, 62 clinicians

Practice addresses (Care Compare)

1515 E Ocean Ave
Lompoc, CA 93436-7092
Phone (805) 588-5845

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.66 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101932875WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lompoc Valley Anesthesia Associates Anesthesiology CurrentSince Jul 1, 2002 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology CurrentSince Jul 26, 2023 Accepting new patients
Vituity-Wisconsin Anesthesia SC Anesthesiology CurrentSince Sep 6, 2024 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jul 26, 2023 Accepting new patients
Vituity-Wisconsin Anesthesia SC Anesthesiology CurrentSince Sep 6, 2024 Accepting new patients
Oak Creek Anesthesia Services, Inc. Anesthesiology CurrentSince Aug 1, 2024 Accepting new patients
Cep America - Anesthesia PC Anesthesiology Past Accepting new patients

Locations

2540 East St
Concord, CA 94520
Phone (925) 674-2228

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

1515 E Ocean Ave
Lompoc, CA 93436
Phone (805) 737-3300

508 E Hickory Ave
Lompoc, CA 93436
Phone (805) 733-3333

136 N 3rd St
Lompoc, CA 93436
Phone (805) 736-1253

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2674 E Main St
Ste E306
Ventura, CA 93003

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Organizations & group practices 7

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 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1700931896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N 3RD ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367002",
            "telephone_number": "805-736-3164",
            "fax_number": "805-736-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E HICKORY AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367337",
            "telephone_number": "805-737-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "CEDRIC",
        "middle_name": "SEKYONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "101932875",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A70537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0058550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.