KEE JIN KWON NP
NPI 1508423567
Nurse Practitioner - Family in San Jose, CA

Q: 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.

Q: What is Kee Jin Kwon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: 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.

Active since May 24, 2019PECOS EnrolledAccepts Medicare Assignment

4855 ATHERTON AVE STE 101, SAN JOSE, CA 95130(408) 963-2400 Get Directions Write a Review

NPPES record last updated: January 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 23, 2023, May 24, 2019 (2 updates tracked since 2019).

On this page

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

NPI1508423567

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameKEE JIN KWONCredential: NP

Location Address4855 ATHERTON AVE STE 101San Jose, CA 95130-1026

Mailing Address906 Rancho PlSan Jose, CA 95126-5204 · (408) 482-4241

Phone(408) 963-2400

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMay 24, 2019

Last NPPES UpdateJanuary 23, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 23, 2023

✔ NPI 1508423567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95011410

4855 ATHERTON AVE STE 101, San Jose, CA 95130

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID4981938057

PECOS Enrollment IDI20200516000004

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 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.

New Patient

$106.47 typical visit price

range $70.37 – $206.04

Typical copayment $26.61 (range $17.59 – $51.51)

Most-billed visit code 99203

Established Patient

$121.77 typical visit price

range $23.96 – $169.60

Typical copayment $30.44 (range $5.99 – $42.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

JULIE DUTTON NP

Nurse Practitioner (Gerontology)