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NICOLE BOON JUNG KWON M.D.
NPI 1427349869
Obstetrics & Gynecology in Santa Rosa, CA

Active since April 20, 2011PECOS EnrolledAccepts Medicare Assignment
34 MARK WEST SPRINGS ROAD, SECOND FLOOR, SANTA ROSA, CA 95403(707) 541-7900(707) 573-5413 Get Directions Write a Review

NPPES record last updated: August 25, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nicole Boon Jung Kwon M.d. NPPES

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

NICOLE BOON JUNG KWON M.D. (NPI 1427349869) is an individual obstetrics & gynecology provider in Santa Rosa, California, licensed in California (A124134) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS and is a graduate of Rush Medical College Of Rush University (2011).

NPPES Registry Identity

NPI1427349869
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameNICOLE BOON JUNG KWONCredential: M.D.
Location Address34 MARK WEST SPRINGS ROAD, SECOND FLOORSanta Rosa, CA 95403
Mailing Address34 Mark West Springs Road, Second FloorSanta Rosa, CA 95403 · (707) 541-7900 · Fax (707) 573-5413
Phone(707) 541-7900
Fax(707) 573-5413
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 2011
Enumeration DateApril 20, 2011
Last NPPES UpdateAugust 25, 2015
✔ NPI 1427349869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in CA · A124134
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
34 MARK WEST SPRINGS ROAD, Santa Rosa, CA 95403
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Other Names 1

Former Name (1)Boon Jung Kwon

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Boon Jung Kwon M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971818527
PECOS Enrollment IDI20150812006886
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Nicole Kwon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Santa Rosa Community Health Centers
1.5 mi
Federally Qualified Health Center (FQHC)
3569 ROUND BARN CIRCLE
Santa Rosa, CA 95403
  • Reassigned Medicare billing, California enrollment
  • 215 clinicians in this Medicare group
NPI 1578631172 (707) 303-3600
Sutter Bay Medical Foundation
53 mi
Multi-Specialty
12 CAMINO ENCINAS
Orinda, CA 94563
  • Reassigned Medicare billing, California enrollment
  • 4,479 clinicians in this Medicare group
NPI 1366898538 (510) 204-8180

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
99 services40 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
20 services19 patients
Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
15 services15 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients
Pessary, reusable, rubber, any type A4561
A pessary is a device placed in the body to help support areas that have dropped due to age, childbirth, or heavy lifting. It's typically made of rubber and is shaped to fit comfortably. It's a non-surgical way to manage certain health conditions.
13 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 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
$142.00 typical visit price
range $63.04 – $187.01
Typical copayment $35.50 (range $15.76 – $46.75)
Most-billed visit code 99204
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
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 Nicole Kwon's NPI number?

The NPI number for Nicole Kwon is 1427349869. It was assigned to this individual provider in the NPPES registry on April 20, 2011. The provider is also known as Boon Jung Kwon.

Where is Nicole Kwon located?

Nicole Kwon practices at 34 Mark West Springs Road Second Floor, Santa Rosa, CA 95403. The listed phone number is (707) 541-7900.

What is Nicole Kwon's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Nicole Kwon enrolled in Medicare?

Yes. Nicole Kwon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Nicole Kwon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Kwon reassigns Medicare benefits to 2 organizations: Santa Rosa Community Health Centers (Santa Rosa, CA) and Sutter Bay Medical Foundation (Orinda, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Kwon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Kwon was last updated on August 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.