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SANGWON MOON
NPI 1093211583
Anesthesiology in Phoenix, AZ

Active since April 03, 2018PECOS EnrolledAccepts Medicare Assignment
2601 E ROOSEVELT ST, PHOENIX, AZ 85008(602) 344-5011 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 19, 2022, Aug 8, 2022, Apr 10, 2018 (3 updates tracked since 2018).

About Sangwon Moon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANGWON MOON (NPI 1093211583) is an individual anesthesiology provider in Phoenix, Arizona, licensed in Maryland (H94417) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2018).

NPPES Registry Identity

NPI1093211583
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameSANGWON MOON
Location Address2601 E ROOSEVELT STPhoenix, AZ 85008-4973
Mailing Address2601 E Roosevelt StPhoenix, AZ 85008-4973
Phone(602) 344-5011
Sole ProprietorNo
Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2018
Enumeration DateApril 3, 2018
Last NPPES UpdateAugust 19, 20223 updates tracked since enumeration
NPPES CertifiedAugust 19, 2022
✔ NPI 1093211583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in MD · H94417
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2601 E ROOSEVELT ST, Phoenix, AZ 85008
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sangwon Moon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820471063
PECOS Enrollment IDI20220819002215, I20220822002036
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sangwon Moon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc
1,965 mi
Health Maintenance Organization
12255 FAIR OAKS PKWY
Fairfax, VA 22033
NPI 1215058326 (703) 934-5700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOEL PHILIP BETZ M.D.
Emergency Medicine (Emergency Medical Services)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5411
DR. ALI SHAHEEN AL-YAQOOBI M.D.
Internal Medicine
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5411
MARICOPA INTEGRATED HEALTH SYSTEM
General Acute Care Hospital
2601 E ROOSEVELT ST, DEPARTMENT OF MEDICINE
PHOENIX, AZ 85008
Maricopa County (602) 344-5366
OWEN THOMAS MCCABE MD
Surgery (Trauma Surgery)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
BRIGHAM NICOLL
Psychiatry & Neurology (Psychiatry)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
DR. AMELIA CATHERINE VAN HANDEL M.D.
Plastic Surgery
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (410) 999-0858
KEVIN YANG
Psychiatry & Neurology (Psychiatry)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
STEPHANIE BERKSHIRE DO
Internal Medicine
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5892

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sangwon Moon's NPI number?

The NPI number for Sangwon Moon is 1093211583. It was assigned to this individual provider in the NPPES registry on April 3, 2018.

Where is Sangwon Moon located?

Sangwon Moon practices at 2601 E Roosevelt St, Phoenix, AZ 85008. The listed phone number is (602) 344-5011.

What is Sangwon Moon's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Sangwon Moon enrolled in Medicare?

Yes. Sangwon Moon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Sangwon Moon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sangwon Moon reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc (Fairfax, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sangwon Moon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sangwon Moon was last updated on August 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.