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BOGUM KWON PA
NPI 1710401484
Physician Assistant in Great Neck, NY

Active since August 03, 2017PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
833 NORTHERN BLVD, GREAT NECK, NY 11021(516) 498-8400 Get Directions Write a Review

NPPES record last updated: July 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2025, Aug 3, 2017 (2 updates tracked since 2017).

About Bogum Kwon Pa NPPES

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

BOGUM KWON PA (NPI 1710401484) is an individual physician assistant in Great Neck, New York, licensed in New York (021238) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS, is affiliated with North Shore University Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1710401484
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameBOGUM KWONCredential: PA
Location Address833 NORTHERN BLVDGreat Neck, NY 11021-5315
Mailing Address833 Northern Blvd Ste 160Great Neck, NY 11021-5322 · (516) 498-8400
Phone(516) 498-8400
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateAugust 3, 2017
Last NPPES UpdateJuly 9, 20252 updates tracked since enumeration
NPPES CertifiedJuly 9, 2025
✔ NPI 1710401484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 021238
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.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X
833 NORTHERN BLVD, Great Neck, NY 11021
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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 and accepts Medicare assignment

Bogum Kwon Pa 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 ID7416216544
PECOS Enrollment IDI20180118001919
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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Shore University Hospital

Acute Care Hospitals · Manhasset, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330106
Location300 Community DriveManhasset, NY 11030 · Nassau County
Emergency services Birthing friendly

Northwell Hospital Glen Cove

Acute Care Hospitals · Glen Cove, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330181
Location101 St Andrews LaneGlen Cove, NY 11542 · Nassau County
Emergency services

St Francis Hospital - The Heart Center

Acute Care Hospitals · Roslyn, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number330182
Location100 Port Washington BoulevardRoslyn, NY 11576 · Nassau County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11021 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSH WERBER M.D.
Otolaryngology
833 NORTHERN BLVD, STE 260
GREAT NECK, NY 11021
Nassau County (516) 829-3466
DR. JONATHAN BANK M.D.
Plastic Surgery
833 NORTHERN BLVD, STE 160
GREAT NECK, NY 11021
Nassau County (516) 498-8400
DR. CAROLE ROCHELLE LERMAN MD
Psychiatry & Neurology (Neurology)
833 NORTHERN BLVD, SUITE 210
GREAT NECK, NY 11021
Nassau County (516) 829-0033
TUROW & TIERNEY PEDIATRICS, PC
Pediatrics
833 NORTHERN BLVD, SUITE 140
GREAT NECK, NY 11021
Nassau County (516) 504-0606
ALFRED JOHN TRUFELLI JR.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
833 NORTHERN BLVD, SUITE 100
GREAT NECK, NY 11021
Nassau County (516) 487-4433
EDWARD L. MILLS, M.D., P.C.
Orthopaedic Surgery
833 NORTHERN BLVD, SUITE 220
GREAT NECK, NY 11021
Nassau County (516) 622-7945
MRS. EVA M. TACZANOWSKI BERSIN P.A.
Physician Assistant (Surgical)
833 NORTHERN BLVD
GREAT NECK, NY 11021
Nassau County (516) 498-8400
SKLANSKY MEDICAL
Clinic/Center
833 NORTHERN BLVD, SUITE 115
GREAT NECK, NY 11021
Nassau County (516) 504-1800

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 Bogum Kwon's NPI number?

The NPI number for Bogum Kwon is 1710401484. It was assigned to this individual provider in the NPPES registry on August 3, 2017.

Where is Bogum Kwon located?

Bogum Kwon practices at 833 Northern Blvd, Great Neck, NY 11021. The listed phone number is (516) 498-8400.

What is Bogum Kwon's specialty?

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

Is Bogum Kwon enrolled in Medicare?

Yes. Bogum 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.

Is Bogum Kwon affiliated with any hospitals?

According to CMS data, Bogum Kwon is affiliated with North Shore University Hospital, Northwell Hospital Glen Cove and St Francis Hospital - The Heart Center.

When was this NPI record last updated?

The NPPES record for Bogum Kwon was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.