Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sangwon Moon

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1093211583

Sangwon Moon is an Anesthesiology in Phoenix, Arizona. Graduated from Arizona College of Osteopathic Medicine Mid Western University in 2018, 8 years ago. Practices with Kaiser Foundation Health Plan of the Mid Atlantic States, Inc, a 1,934-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
8
Trained at
Arizona College of Osteopathic Medicine Mid Western University
Licensed in
MD
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone: (602) 344-5011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence H94417 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1093211583
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 3, 2018
Last updated in NPPESAugust 19, 2022
Certification dateAugust 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated 2018 (8 years in practice)
Group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc — 1934 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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