Soo Yun Kwon, M.D.

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

ME153058 Issued in FL

Practice address

2 Tampa General Cir
Tampa, FL 33606-3571

Phone

(813) 821-8038

Fax

(813) 974-0483

NPI assigned

Sep 26, 2005

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skwon273122@direct.tgh.org
• Direct secure messaging: sookwon@northwell.allscriptsdirect.net
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: skwon1283178@nychhc.direct-ci.com
• Direct secure messaging: sookwon@nslijmedgr.allscriptsdirect.net

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.

• Metropolitan Medical Practice Plan PC

  • General Practice Physician
  • New York, NY
  • NPI 1306138383
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• University Medical Service Association Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1992742324
  NPD
• Northwell Health

  • Rehabilitation Hospital Unit
  • Glen Cove, NY
  • NPI 1619336260
  NPD
• Chicago Gynecologic Oncology, S.C.

  • Specialist
  • Schaumburg, IL
  • NPI 1548256506
  NPD (past)
• Copley Memorial Hospital, Inc.

  dba Rush Copley Multispecialty Group Practice

  • Endocrinology, Diabetes & Metabolism Physician
  • Aurora, IL
  • NPI 1619466034
  NPD (past)
• Illinois Urogynecology, LTD.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Park Ridge, IL
  • NPI 1063421899
  NPD (past)
• JHMC Diagnostic and Treatment Center

  • Family Medicine Physician
  • Jamaica, NY
  • NPI 1821045485
  NPD (past)
• New York City Health and Hospitals Corporation

  dba East New York Diagnostic & Treatment Center

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1063577831
  NPD (past)
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1790771657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "969 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100280322",
            "country_code": "US",
            "telephone_number": "212-288-0185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "SOO",
        "middle_name": "YUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "IL",
            "license": "036112116",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "FL",
            "license": "ME153058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "072Y4",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118695300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skwon273122@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Alexander Kwaznicki, MSW
• Glenn A Kwiat, MD
• Geoffrey Malcom Kwitko, M.D.
• Ashley Nunghee Kwon, DO
• Mi Ae Kwon, D.M.D.
• Aye Suu Kyi
• Kyle J Day, LCSW, L.L.C.
• Colleen G Kyle, M.S., SLP
• Russell Lee Kyle, CRSS, CMMF
• Tiffany Kyper, MSW

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.