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BUM WON KWAK PA
NPI 1093505257
Physician Assistant in Los Angeles, CA

Active since May 10, 2025PECOS Enrolled
966 S WESTMORELAND AVE APT 1, LOS ANGELES, CA 90006(315) 804-1825 Get Directions Write a Review

NPPES record last updated: May 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bum Won Kwak Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BUM WON KWAK PA (NPI 1093505257) is an individual physician assistant in Los Angeles, California and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1093505257
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameBUM WON KWAKCredential: PA
Location Address966 S WESTMORELAND AVE APT 1Los Angeles, CA 90006-5611
Mailing Address966 S Westmoreland Ave Apt 1Los Angeles, CA 90006-5611 · (315) 804-1825
Phone(315) 804-1825
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMay 10, 2025
NPPES CertifiedMay 10, 2025
✔ NPI 1093505257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
966 S WESTMORELAND AVE APT 1, Los Angeles, CA 90006
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bum Won Kwak Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810405107
PECOS Enrollment IDI20250806003887
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90006 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bum Kwak's NPI number?

The NPI number for Bum Kwak is 1093505257. It was assigned to this individual provider in the NPPES registry on May 10, 2025.

Where is Bum Kwak located?

Bum Kwak practices at 966 S Westmoreland Ave Apt 1, Los Angeles, CA 90006. The listed phone number is (315) 804-1825.

What is Bum Kwak's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Bum Kwak enrolled in Medicare?

Yes. Bum Kwak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bum Kwak was last updated on May 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.