KEE JIN KWON NP
NPI 1508423567
Nurse Practitioner - Family in San Jose, CA
About Kee Jin Kwon Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEE JIN KWON NP (NPI 1508423567) is an individual family provider in San Jose, California, licensed in California (95011410) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
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
Kee Jin Kwon Np 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.
Medicare Billing Reassignment
Medicare enrollment records show Kee Jin Kwon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Santa Clara, CA 95051
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95130 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN JOSE, CA 95130
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 Kee Jin Kwon's NPI number?
The NPI number for Kee Jin Kwon is 1508423567. It was assigned to this individual provider in the NPPES registry on May 24, 2019.
Where is Kee Jin Kwon located?
Kee Jin Kwon practices at 4855 Atherton Ave Ste 101, San Jose, CA 95130. The listed phone number is (408) 963-2400.
What is Kee Jin Kwon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kee Jin Kwon enrolled in Medicare?
Yes. Kee Jin 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 organization bills Medicare for Kee Jin Kwon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kee Jin Kwon reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, CA). The 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 Kee Jin 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 Kee Jin Kwon was last updated on January 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Kee Jin Kwon, NP · NPI 1508423567
Family physician in San Jose, California. Individual provider, active in the CMS NPPES registry since May 24, 2019.
## Identity
- **NPI:** 1508423567 (Entity type: Individual)
- **Enumerated:** May 24, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95011410 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4855 ATHERTON AVE STE 101, San Jose, CA 95130-1026
- **Phone:** (408) 963-2400
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1073606299, Santa Clara, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** January 23, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1508423567) · Data from the CMS NPPES public registry.