Individual provider Active NPI

Ik H Kwon, MD

  • Internal Medicine Physician
  • South Plainfield, NJ
National Provider Identifier
1902821317
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA025605 Issued in NJ
Practice address
1526 New Durham Rd
South Plainfield, NJ 07080-2317
Phone
(732) 287-2273
Fax
(732) 287-4093
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA025605 NJ Primary

Addresses

Primary practice location

1526 New Durham Rd
South Plainfield, NJ 07080-2317

Mailing address

1526 New Durham Rd
South Plainfield, NJ 07080-2317
Phone (732) 287-2273

Other identifiers 1

IdentifierTypeStateIssuer
1825305MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA025605NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902821317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 NEW DURHAM RD",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070802317",
            "telephone_number": "732-287-2273",
            "fax_number": "732-287-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 NEW DURHAM RD",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070802317",
            "telephone_number": "732-287-2273",
            "fax_number": "732-287-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "IK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA025605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1825305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Plainfield, NJ

Sources for this page

Verify at the official NPI Registry.