Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Joonkwon Bak

Individual provider Medical Physician Assistant · NPI 1356868301

Joonkwon Bak is a Physician Assistant in Bronx, New York. Qualified in 2017, 9 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1825 Eastchester Rd # 7NW
Bronx, NY 10461-2301
Phone: (718) 904-3101
Fax: (718) 904-2827
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 021224 (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 021224 (NY)

Record details

NPI number1356868301
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 29, 2017
Last updated in NPPESJuly 21, 2022
Certification dateMarch 15, 2022
Mailing address1825 Eastchester Rd # 7nw, Bronx, NY 10461-2301

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations22 on file with Medicare

Other providers in Bronx