Individual provider Active NPI

Si Woo An

  • Physician Assistant
  • Duluth, GA
National Provider Identifier
1356063341
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3610 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5139
Phone
(678) 417-0332
NPI assigned
Sep 15, 2022
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3610 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5139

Mailing address

3 Wild Turkey LN
Rock Tavern, NY 12575-5419
Phone (201) 364-8465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506000707 NY Practitioner - Physician Assistant 2769822956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
031399NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barbour Orthopaedics & Sports Medicine PC Past Accepting new patients
Woun Hue Seok DO PC PastSince Jul 17, 2018 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1356063341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WILD TURKEY LN",
            "city": "ROCK TAVERN",
            "state": "NY",
            "postal_code": "125755419",
            "telephone_number": "201-364-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 PEACHTREE INDUSTRIAL BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965139",
            "telephone_number": "678-417-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AN",
        "first_name": "SI WOO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-15",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.