Individual provider Active NPI

Yong Kyu Kwon, PA

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1699414474
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA200001511 Issued in DC
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 741-2911
Fax
(202) 741-2921
NPI assigned
Jun 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA200001511 DC Primary

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 741-2911

Other names 1

  • Mr. Paul Kwon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20220822000773 DC Practitioner - Physician Assistant 5193108371 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA200001511DCMDMedical Physician Assistant

Organizations & group practices 1

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1699414474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-741-2911",
            "fax_number": "202-741-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-741-2911",
            "fax_number": "202-741-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "YONG",
        "middle_name": "KYU",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-08-05",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA200001511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "KWON",
            "prefix": "MR.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.