Individual provider Active NPI

Nayoung Kwak

  • Family Medicine Physician
  • Buffalo, NY
National Provider Identifier
1104766526
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1104766526 Issued in NY
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

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
1104766526NYMDFamily 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.

Verify at the official NPI Registry.