Jaehong Gwag, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

33437 Issued in AZ

Practice address

2421 E Southern Ave Ste 7
Tempe, AZ 85282-7612

Phone

(480) 425-2160

Fax

(480) 351-8797

NPI assigned

Apr 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Anesthesiology

Education

State University of New York at Stony Brook, School of Medicine, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaehonggwag@asjh.medalliesdirect.net

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.

• Drgwag PLLC

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1811662687
  Medicare reassignment NPD Authorized official
• Camelback Anesthesia PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Tempe, AZ
  • NPI 1831560176
  Medicare reassignment NPD
• Valley Anesthesiology Consultants, Inc.

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1285660704
  Medicare reassignment NPD
• Arizona Spine and Joint Hospital LLC

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1396745832
  NPD
• Old Pueblo Anesthesia

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1194770768
  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1972569804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852741150",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE STE 7",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWAG",
        "first_name": "JAEHONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "33437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "959257",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Alexis Gutierrez Ortiz, LPN
• Adylia Gutierrez
• Victoria Nicole Gutierrez
• Michael David Guttenplan, MD
• Kenia Guzman, RBT
• H.O.P.E. Group, LLC.
• Anuneet K Haas, MD
• Natasha Haas, RBT
• Alan Jerald Haberman, BCBA
• Mohamed Habib, RPH.

• Anesthesiology Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.