Si Woo An
Individual provider Active NPI Physician Assistant · Duluth, GA
NPI 1356063341 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1356063341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 3610 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5139 - Phone
- (678) 417-0332
- NPI assigned
- Sep 15, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240506000707 | NY | Practitioner - Physician Assistant | 2769822956 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barbour Orthopaedics & Sports Medicine PC | Past | Accepting new patients | |
| Woun Hue Seok DO PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
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
Other providers in Duluth, GA
- America'S Best Contacts & Eyeglasses
- Americare, LLC.
- Amerita South Atlantic LLC
- Sook Sung An Kil
- Jin-Young An
- Chinedu Anaje
- Aneesha Ananthula
- Anchor Plus RX, LLC
- Anderson and Anderson DMD PC
- Amy Caroline Anderson
All providers in Duluth, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.