Active NPI
Jasmine Kwack, PA-C
- Physician Assistant
- Corona, CA
National Provider Identifier
1427925734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 110 N Lincoln Ave Ste 100
Corona, CA 92882-1853 - Phone
- (833) 867-8462
- NPI assigned
- Oct 21, 2025
- Last updated
- Aug 11, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
110 N Lincoln Ave Ste 100
Corona, CA 92882-1853
Mailing address
110 N Lincoln Ave Ste 100
Corona, CA 92882-1853
Phone (833) 867-8462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3634 Elizabeth St
Riverside, CA 92506-2506
Phone (951) 788-0008
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skilled Provider Network | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Riverside, CA
- NPI 1245892066
-
- General Practice Physician
- Corona, CA
- NPI 1528913597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1427925734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 N LINCOLN AVE STE 100",
"city": "CORONA",
"state": "CA",
"postal_code": "928821853",
"telephone_number": "833-867-8462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 N LINCOLN AVE STE 100",
"city": "CORONA",
"state": "CA",
"postal_code": "928821853",
"telephone_number": "833-867-8462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWACK",
"first_name": "JASMINE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-10-21",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.