Kevin I Pak, MD

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

247616-B18 Issued in NY

Practice address

7206 Northern Blvd
2ND Floor
Jackson Heights, NY 11372-1049

Phone

(866) 670-6824

Fax

(178) 533-1774

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ikyo Pak Former name

Electronic endpoints 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and RehabilitationAlso: Sports Medicine

Education

State University of New York Downstate Medical Center, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

85.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: kip9028@direct.nyp.org

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.

• New York Queens Medicine and Surgery, P.C.

  • Pediatrics Physician
  • Fresh Meadows, NY
  • NPI 1003114851
  Medicare reassignment Care Compare group
• Hudson Spine and Pain Medicine, PC

  • Pain Clinic/Center
  • New York, NY
  • NPI 1639418858
  Medicare reassignment
• Physio Logic Medicine, P.C.

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1013293588
  Medicare reassignment
• Physiologic Chiropractic & Physical Therapy, PLLC.

  • Chiropractor
  • Brooklyn, NY
  • NPI 1225262785
  NPD
• University Physicians of Brooklyn, Inc.

  • Orthopaedic Surgery Physician
  • Brooklyn, NY
  • NPI 1386691822

  Physical Medicine & Rehabilitation

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New York Hospital Queens Ambulance

  • Land Ambulance
  • Flushing, NY
  • NPI 1295857092

  Hospital

  Care Compare affiliation
• New York-Presbyterian-Queens

  • Clinical Medical Laboratory
  • Flushing, NY
  • NPI 1053429274

  Hospital

  Care Compare affiliation
• Newyork-Presbyterian-Queens

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1689958779

  Hospital

  Care Compare affiliation
• Newyork-Presbyterian-Queens

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1952347205
  Care Compare affiliation

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1508922527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7206 NORTHERN BLVD",
            "address_2": "2ND FLOOR",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721049",
            "telephone_number": "866-670-6824",
            "fax_number": "178-533-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7206 NORTHERN BLVD",
            "address_2": "2ND FLOOR",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721049",
            "telephone_number": "866-670-6824",
            "fax_number": "178-533-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "KEVIN",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MT184507",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "247616-B18",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03143491",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "7206 Northern Blvd",
            "address_2": "2nd Floor",
            "city": "Jackson Heights",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113721049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "7206 Northern Blvd",
            "address_2": "2nd Floor",
            "city": "Jackson Heights",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113721049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kip9028@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "7206 Northern Blvd",
            "address_2": "2nd Floor",
            "city": "Jackson Heights",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113721049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IKYO",
            "last_name": "PAK",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• P.R. Medical PC
• Jorge Luis Padilla
• Migdalia Maria Padilla, P.T.
• Stephanie Paguay
• Pak Podiatry
• Lucy Palacios
• Maria Sol Paladines Jaramillo
• Julio Cesar Palma, M.D.
• Tiandra Palmer
• Emilia Ramirez Panday, MD

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.

Verify at the official NPI Registry.