Active NPI
Nayoung Kwak
- Family Medicine Physician
- Buffalo, NY
National Provider Identifier
1104766526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1104766526
- Practice address
- 184 Barton St
Buffalo, NY 14213-1573 - Phone
- (716) 881-6191
- NPI assigned
- Mar 30, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1104766526 | NY | Primary |
Addresses
Primary practice location
184 Barton St
Buffalo, NY 14213-1573
Mailing address
916 Delaware Ave Apt 5C
Buffalo, NY 14209-1851
Phone (405) 615-5597
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1104766526 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777852800000",
"number": "1104766526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 DELAWARE AVE APT 5C",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142091851",
"telephone_number": "405-615-5597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 BARTON ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142131573",
"telephone_number": "716-881-6191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAK",
"first_name": "NAYOUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-30",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "1104766526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.