Active NPI
Samuel Kuo
- Home Health Agency
- Brooklyn Park, MN
National Provider Identifier
1073215497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1118231
- Practice address
- 5228 94TH LN N
Brooklyn Park, MN 55443-2434 - Phone
- (612) 695-5091
- NPI assigned
- Mar 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1118231 | MN | Primary |
Addresses
Primary practice location
5228 94TH LN N
Brooklyn Park, MN 55443-2434
Mailing address
5228 94TH LN N
Brooklyn Park, MN 55443-2434
Phone (608) 628-6128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1118231 | MN | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1073215497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5228 94TH LN N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554432434",
"telephone_number": "608-628-6128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5228 94TH LN N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554432434",
"telephone_number": "612-695-5091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUO",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-20",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MN",
"license": "1118231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.