Byung San Kwak, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

41865 Issued in AL

Practice address

1331 Old Oak PL
Montgomery, AL 36117-6895

Phone

(334) 746-5586

Fax

(800) 317-0547

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• San Byung Kwak Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Psychiatry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ground Up Behavioral Health LLC

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1902695661
  Medicare reassignment NPD Authorized official
• Grace Point Behavioral LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montgomery, AL
  • NPI 1720404619
  NPD
• Community Hospital Inc

  • Rural Acute Care Hospital
  • Tallassee, AL
  • NPI 1730120726
  NPD (past)
• Community Hospital Inc

  • Psychiatric Hospital Unit
  • Tallassee, AL
  • NPI 1912043134
  NPD (past)

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1073967782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 OLD OAK PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361176895",
            "fax_number": "800-317-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 OLD OAK PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361176895",
            "telephone_number": "334-746-5586",
            "fax_number": "800-317-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "BYUNG",
        "middle_name": "SAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "41865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAN",
            "last_name": "KWAK",
            "middle_name": "BYUNG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Krishna Krothapalli, DO
• Binay Kumar Kshetree, MD
• Akshay Kumar Bajaj, M.D.
• Nitish Kumar, MD
• Ira Martin Kupferberg, M.D.
• Song-Ei Kwon
• L Wayne Yarbrough DMD
• Laboratory Acquisition Company PC
• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings

• Psychiatry Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Psychiatry Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.