Individual provider Active NPI

Hoseok Kwak

  • Chiropractor
  • Flushing, NY
National Provider Identifier
1255626875
Registry record updated Jun 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
70 012029 Issued in NY
Practice address
15015 41St Ave Ste 3E
Flushing, NY 11354-4929
Phone
(718) 886-0055
Fax
(718) 321-8524
NPI assigned
Jun 11, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 70 012029 NY Primary

Addresses

Primary practice location

15015 41St Ave Ste 3E
Flushing, NY 11354-4929

Mailing address

2845 Strauss Ter
Silver Spring, MD 20904-7148
Phone (240) 461-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110719000232 NY Practitioner - Chiropractic 3476721499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19122 Northern Blvd
Flushing, NY 11358-2829
Phone (718) 886-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012029NYMDMental Health Counselor
70 012029NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Joeun Chiropractic PC Chiropractor PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1307750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307750400000",
    "number": "1255626875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 STRAUSS TER",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047148",
            "telephone_number": "240-461-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 41ST AVE STE 3E",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544929",
            "telephone_number": "718-886-0055",
            "fax_number": "718-321-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "HOSEOK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-11",
        "last_updated": "2011-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "70 012029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.