Jake S Kwon, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

N005468 Issued in NY

Practice address

4232 Francis Lewis Blvd # C
Bayside, NY 11361-2561

Phone

(646) 389-6485

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Wake Forest University School of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Kwon Podiatry PC

  • Foot & Ankle Surgery Podiatrist
  • Bayside, NY
  • NPI 1780310003

  Primary Podiatric Medicine

  Medicare reassignment NPD Authorized official
• Kwon Podiatry NJ PC

  • Podiatrist
  • Fort Lee, NJ
  • NPI 1588382881

  Primary Podiatric Medicine

  Medicare reassignment NPD Authorized official
• Marcjonathan Serota MD, P.C.

  • Dermatology Physician
  • Bayside, NY
  • NPI 1598481251
  NPD

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1629129887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 PILGRIM LN",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906218",
            "telephone_number": "646-389-6485",
            "fax_number": "718-939-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4232 FRANCIS LEWIS BLVD # C",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612561",
            "telephone_number": "646-389-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "JAKE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N005468",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD002511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Alexander Kuncio, DDS
• Zenovia Didoshak Kuncio, DDS
• Won Seok Kwag
• Kwon Podiatry PC
• Hanna Kwon
• John Kwon, PA-C
• So Young Kwon, PT
• Sunga Kwon
• Kzark Medical P.C.
• Naomi Aaronson L.

• Primary Podiatric Medicine Podiatrist in Bayside, NY
• Providers in Bayside, NY by specialty
• Primary Podiatric Medicine Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.

Verify at the official NPI Registry.