Andrew Kwak, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25MA09159500 Issued in NJ

Practice address

300 2ND Ave
Monmouth Medical Center - Department of Radiology
Long Branch, NJ 07740-6303

Phone

(732) 923-6806

NPI assigned

Jul 13, 2007

Last updated

Feb 24, 2015By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Diagnostic Radiology

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Imaging Services LLCGroup PAC ID 1850724386, 122 clinicians

Associated Valley Radiologists, LTDGroup PAC ID 8325388499, 59 clinicians

Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
• Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093
• Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 70)

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.

• Associated Valley Radiologists LTD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1932683257
  Medicare reassignment Care Compare group NPD
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Sun City, AZ
  • NPI 1770139958
  Medicare reassignment Care Compare group NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment NPD
• Page Hospital

  • Critical Access Hospital
  • Page, AZ
  • NPI 1578515789
  Medicare reassignment NPD
• Toca at Banner Health LLC

  • Orthopaedic Surgery Physician
  • Glendale, AZ
  • NPI 1386270932
  Medicare reassignment NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1316294242
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1780445171
  NPD
• Banner Imaging Services LLC

  • Radiology Clinic/Center
  • Phoenix, AZ
  • NPI 1710733472
  NPD
• Banner Imaging Services LLC

  • Diagnostic Radiology Physician
  • Casa Grande, AZ
  • NPI 1841846920
  NPD
• Page Hospital

  • Rural Health Clinic/Center
  • Page, AZ
  • NPI 1902317829
  NPD
• Toca at Banner Health LLC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1922622513
  NPD

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

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Boswell Medical Center

  • General Acute Care Hospital
  • Sun City, AZ
  • NPI 1952560914
  Care Compare affiliation
• Banner del E Webb Medical Center

  • General Acute Care Hospital
  • Sun City West, AZ
  • NPI 1588823553
  Care Compare affiliation
• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  Care Compare affiliation

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1740489418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "address_2": "MONMOUTH MEDICAL CENTER - DEPARTMENT OF RADIOLOGY",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "address_2": "MONMOUTH MEDICAL CENTER - DEPARTMENT OF RADIOLOGY",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "49954",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA09159500",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A115256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONMOUTH",
            "identifier": "390200000X",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David C Kramer, M.D.
• Jonathan Kristan, M.D.
• Amanda Dawn Kube, NCPRSS
• Natalya Kugay, MD
• Jonathan Kurian, PHARMD
• Gloria Labib
• Laboratory Medicine Associates
• Laboratory Medicine Associates, PA
• Ladacin Network
• Ladacin Network

• Diagnostic Radiology Physician in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.