Organization Active NPI

S W Baik M D P a

  • Specialist
  • Fort Lee, NJ
National Provider Identifier
1790746782
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
S W BAIK M D P A
Practice address
1608 Lemoine Ave
Suite 200
Fort Lee, NJ 07024-5622
Phone
(201) 302-9774
Fax
(201) 482-0664
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Authorized official

Name
Seoung Won BaikNPI 1902877327
Title
Physician
Phone
(201) 302-9774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1608 Lemoine Ave
Suite 200
Fort Lee, NJ 07024-5622

Mailing address

1608 Lemoine Ave Ste 200
Fort Lee, NJ 07024-5636
Phone (201) 302-9774

Other identifiers 1

IdentifierTypeStateIssuer
3936406MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091026000206 NJ Part B Supplier - Clinic/Group Practice 3870676075 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Lee, NJ

National Provider Directory

National Provider Directory

Locations

1608 Lemoine Ave
Ste 200
Fort Lee, NJ 07024
Phone (201) 302-9774

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1790746782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 LEMOINE AVE STE 200",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245636",
            "telephone_number": "201-302-9774",
            "fax_number": "201-482-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 LEMOINE AVE",
            "address_2": "SUITE 200",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245622",
            "telephone_number": "201-302-9774",
            "fax_number": "201-482-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S W BAIK M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "BAIK",
        "authorized_official_first_name": "SEOUNG",
        "authorized_official_middle_name": "WON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "201-302-9774"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3936406",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.