Individual provider Active NPI

Sarah Y Kwon, PA-C

  • Physician Assistant
  • Valley Stream, NY
National Provider Identifier
1407617129
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1215894 Issued in PA
Practice address
70 E Sunrise Hwy Ste 515W
Valley Stream, NY 11581-1233
Phone
(516) 663-1365
Fax
(516) 710-7685
NPI assigned
Jan 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 1215894 PA Primary

Addresses

Primary practice location

70 E Sunrise Hwy Ste 515W
Valley Stream, NY 11581-1233

Mailing address

129 37TH St Apt 705
Union City, NJ 07087-5987
Phone (484) 649-2927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240606003871 NJ Practitioner - Physician Assistant 8123560042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Son Dermatology PCGroup PAC ID 1153473046, 2 clinicians

Practice addresses (Care Compare)

200 Grand Ave
Suite 201
Englewood, NJ 07631-4363
Phone (201) 944-3800

243 Chestnut St
Suite 3
Newark, NJ 07105-6501
Phone (973) 522-0300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1215894PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Pediatrics, LLC Past 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": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1407617129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 37TH ST APT 705",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875987",
            "telephone_number": "484-649-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 E SUNRISE HWY STE 515W",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811233",
            "telephone_number": "516-663-1365",
            "fax_number": "516-710-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "SARAH",
        "middle_name": "Y",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "1215894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.