1. Home
  2. Directory
  3. California
  4. Alhambra
  5. Nurse Practitioner
  6. NPI Profile

JIAE KWAK FNP
NPI 1912677253
Nurse Practitioner - Family in Alhambra, CA

Active since September 17, 2021PECOS Enrolled
1001 S GARFIELD AVE, ALHAMBRA, CA 91801(310) 803-7648 Get Directions Write a Review

NPPES record last updated: September 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jiae Kwak Fnp NPPES

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

JIAE KWAK FNP (NPI 1912677253) is an individual family provider in Alhambra, California, licensed in California (95018394) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912677253
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJIAE KWAKCredential: FNP
Location Address1001 S GARFIELD AVEAlhambra, CA 91801-4772
Mailing Address1001 S Garfield AveAlhambra, CA 91801-4772 · (310) 803-7648
Phone(310) 803-7648
Sole ProprietorYes
Enumeration DateSeptember 17, 2021
NPPES CertifiedSeptember 17, 2021
✔ NPI 1912677253 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 · 95018394
1001 S GARFIELD AVE, Alhambra, CA 91801
Open in Google Maps ↗

Other Names 1

Professional Name (2)Vicky Kwak Fnp

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jiae Kwak Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Jiae Kwak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Arroyo Vista Family Health Foundation
3.2 mi
Federally Qualified Health Center (FQHC)
4837 HUNTINGTON DR N
Los Angeles, CA 90032
  • Reassigned Medicare billing, California enrollment
  • 61 clinicians in this Medicare group
NPI 1821302027 (323) 225-0024

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 91801 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
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

MICHELLE DOMINIQUE DE SANTO D.O.
General Practice
1001 S GARFIELD AVE
ALHAMBRA, CA 91801
Los Angeles County (818) 788-4513
PHYSICIAN NETWORK SPECIALISTS
Internal Medicine
1001 S GARFIELD AVE
ALHAMBRA, CA 91801
Los Angeles County (626) 560-6251
HARMONIQ MEDICAL GROUP P.C
Internal Medicine
1001 S GARFIELD AVE
ALHAMBRA, CA 91801
Los Angeles County (626) 688-5951
GERICARE MEDICAL GROUP
Internal Medicine
1001 S GARFIELD AVE
ALHAMBRA, CA 91801
Los Angeles County (213) 986-7998
CHAN UNITED MEDICAL GROUP, INC.
General Practice
1001 S GARFIELD AVE
ALHAMBRA, CA 91801
Los Angeles County (626) 308-0138

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 Jiae Kwak's NPI number?

The NPI number for Jiae Kwak is 1912677253. It was assigned to this individual provider in the NPPES registry on September 17, 2021. The provider is also known as Vicky Kwak Fnp.

Where is Jiae Kwak located?

Jiae Kwak practices at 1001 S Garfield Ave, Alhambra, CA 91801. The listed phone number is (310) 803-7648.

What is Jiae Kwak's specialty?

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

Is Jiae Kwak enrolled in Medicare?

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

Which organization bills Medicare for Jiae Kwak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jiae Kwak reassigns Medicare benefits to Arroyo Vista Family Health Foundation (Los Angeles, 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 Jiae Kwak'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 Jiae Kwak was last updated on September 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.