HAKYONG GLORIA KWAK (MD) – Ophthalmology Physician, NPI 1366071037
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
429 OPHTHALMOLOGY in TN
Provider Addresses for HAKYONG GLORIA KWAK (MD)
825 RIDGE LAKE BLVD
MEMPHIS, TN 381209411
Phone: (901) 685-2200
Fax: (901) 255-5631
Type: Location
853 JEFFERSON AVE RM E102
MEMPHIS, TN 381032804
Phone: (901) 448-4795
Type: Mailing
920 MADISON AVE STE 447
MEMPHIS, TN 381033438
Phone: (901) 448-4795
Type: Location
PO BOX 22510
JACKSON, MS 392252510
Phone: (901) 685-2200
Fax: (901) 255-5631
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250815002989 | I | Ophthalmology | TN | TBD |
| I20250828005510 | I | Ophthalmology | MS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 38120)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | TN | |
| O P H T H A L M O L O G Y | TN | |
| O P T O M E T R Y | TN | |
| - | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| O P T O M E T R Y | TN | |
| O P H T H A L M O L O G Y | IL |
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