Edward S. Kwak, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

236600 Issued in NY

Practice address

737 Park Ave Apt 1D
New York, NY 10021-4264

Phone

(212) 229-1100

Fax

(212) 229-1105

NPI assigned

Jan 18, 2007

Last updated

Jan 9, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• 737 Park Avenue Surgery Suite, P.C.

  • Ambulatory Surgical Clinic/Center
  • New York, NY
  • NPI 1962951665
  Authorized official Same address or phone
• Physician Associates of Nyeei, LLC

  • Specialist
  • New York, NY
  • NPI 1033153697
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1568514412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 PARK AVE APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214264",
            "telephone_number": "212-229-1100",
            "fax_number": "212-229-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 PARK AVE APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214264",
            "telephone_number": "212-229-1100",
            "fax_number": "212-229-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "EDWARD",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "236600",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "236600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02877961",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally H Kwa, M.D.
• Winston C. Kwa, M.D.
• Joann A. Kwah, M.D.
• Andrew Kwai, MD
• Charles Chang Kwak, PH. D.
• Ha Rim Kwak, MD
• Heeseung Kwak
• Jillian Marie Kwak
• Paul Edward Kwak, M.D.
• Roy Kwak, M.D.

• Facial Plastic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Facial Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.