Active NPI
Edmund Yuey Kun Ko, M.D.
- Urology Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- A116697
- Practice address
- 11370 Anderson St
Suite 1100
Loma Linda, CA 92354-3450 - Phone
- (909) 558-2830
- Fax
- (909) 558-2445
- NPI assigned
- Feb 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | A116697 | CA | Primary |
Addresses
Primary practice location
11370 Anderson St
Suite 1100
Loma Linda, CA 92354-3450
Mailing address
11370 Anderson St
Suite 1100
Loma Linda, CA 92354-3450
Phone (909) 558-2830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0A1166970 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Loma Linda University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A116697 | CA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Beaver Medical Group P C | Urology | Current | Accepting new patients |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Beaver Medical Group P C | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Beaver Medical Group P C | Past | Accepting new patients | |
| Cleveland Clinic Weston Hospital Nonprofit Corporation | Past | Accepting new patients | |
| The Cleveland Clinic Foundation | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Loma Linda University Medical Center | Past | Accepting new patients | |
| Loma Linda University Children'S Hospital | Past | Accepting new patients |
Locations
6109 W Ramsey St
Banning, CA 92220
Phone (909) 845-0313
81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
11370 Anderson St
#1100
Loma Linda, CA 92354
Phone (909) 558-2830
11370 Anderson St
Ste 1100
Loma Linda, CA 92354
Phone (909) 558-2830
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
11234 Anderson St
Rm A560
Loma Linda, CA 92350
Phone (877) 558-6248
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610
26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
2 W Fern Ave
#1112
Redlands, CA 92373
2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137
901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 14
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
- Physical Therapist
- Redlands, CA
- NPI 1427090281
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Upland, CA
- NPI 1083863914
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Fontana, CA
- NPI 1689606196
-
- Family Medicine Physician
- Redlands, CA
- NPI 1275570830
-
- General Acute Care Hospital
- San Bernardino, CA
- NPI 1689769911
-
- Children's Hospital
- Loma Linda, CA
- NPI 1366866345
-
- General Acute Care Hospital
- Loma Linda, CA
- NPI 1194731935
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fontana, CA
- NPI 1356496772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1023081817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST",
"address_2": "SUITE 1100",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450",
"telephone_number": "909-558-2830",
"fax_number": "909-558-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST",
"address_2": "SUITE 1100",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450",
"telephone_number": "909-558-2830",
"fax_number": "909-558-2445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KO",
"first_name": "EDMUND",
"middle_name": "YUEY KUN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-10",
"last_updated": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "A116697",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0A1166970",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "9961 Sierra Ave",
"city": "Fontana",
"state": "CA",
"country_code": "US",
"postal_code": "923356720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.