Tiffany Angie Kwon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007421-1 Issued in NY

Practice address

2014 Calvary Cir Apt 201
Charlottesville, VA 22911-8469

Phone

(909) 569-9290

NPI assigned

Jul 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tiffany Angie Lau Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stephen T Basic III OD and Associates PLLCGroup PAC ID 4082868989, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Stephen T Basic III OD and Associates PLLC

  • Optometrist
  • Charlottesville, VA
  • NPI 1447504519
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1760611362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 CALVARY CIR APT 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118469",
            "telephone_number": "909-569-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 CALVARY CIR APT 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118469",
            "telephone_number": "909-569-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "TIFFANY",
        "middle_name": "ANGIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007421-1",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002533",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03179962",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "LAU",
            "middle_name": "ANGIE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fabian Ludwig Kuttner
• Hana Cecilia Kuwabara
• Emmanuel Kwarfo, AG-ACNP
• Mary Elizabeth Kwiecinski, CNM
• Paul S Kwon, MASTERS IN GC
• Timothy T. Kyin, MD
• Sara La Force, LCSW
• Najwa Labban, PHD
• Emily Tina Labruna
• Tyler Lacey

• Optometrist in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.