Individual provider Active NPI

Edward Kwon

  • Surgical Critical Care Physician
  • Los Angeles, CA
National Provider Identifier
1992029599
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
A120642 Issued in CA
Practice address
2051 Marengo Street
Ipi, C52100
Los Angeles, CA 90033-1029
Phone
(323) 409-7761
Fax
(323) 441-9909
NPI assigned
Mar 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X A120642 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2051 Marengo Street
Ipi, C52100
Los Angeles, CA 90033-1029

Mailing address

510S Hewitt St 406
Los Angeles, CA 90013-1659
Phone (646) 702-7609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20140307000212 CA Practitioner - General Surgery 6002086261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tulane University School of Medicine, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Desert Trauma Surgeons IncGroup PAC ID 0547366106, 36 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone (626) 397-5112

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
97.68
Improvement activities
40
Cost
62.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13574NVMDNutrition Support Pharmacist
A120642CAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Trauma Surgeons, Inc. Surgical Critical Care CurrentSince Jan 1, 2021 Accepting new patients
Edward Kwon MD Inc CurrentSince Aug 10, 2015 Accepting new patients

Locations

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

35 E Glenarm St
Pasadena, CA 91105
Phone (626) 768-4415

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1992029599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510S HEWITT ST 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131659",
            "telephone_number": "646-702-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 MARENGO STREET",
            "address_2": "IPI, C52100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-7761",
            "fax_number": "323-441-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A120642",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.