Charlotte Haeran Koo, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036139709 Issued in IL

Practice address

2100 Pfingsten Rd Ste 3001a
Glenview, IL 60026-1301

Phone

(847) 657-5840

Fax

(847) 657-5732

NPI assigned

Apr 8, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner - University Hospital Based Physicians LLCGroup PAC ID 1052614294, 343 clinicians

Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Ironwood Medical Center Hospital, Queen Creek, AZ, CCN 030130
• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
• Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Banner Goldfield Medical Center Hospital, Apache Junction, AZ, CCN 030134

Merit-based Incentive Payment System (MIPS)

Final score

83.7 of 100Reported as group

Quality

64.97

Promoting interoperability

98

Improvement activities

40

Cost

69.88

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Banner - University Hospital Based Physicians LLC

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1750751566
  Medicare reassignment Care Compare group NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment Care Compare group NPD
• Banner Cancer Center Specialists LLC

  • Oncology Clinic/Center
  • Phoenix, AZ
  • NPI 1518253152
  Medicare reassignment NPD
• Lifeline Hospitalist Associates LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1265107478
  Medicare reassignment NPD
• Arizona Post Acute Care Specialists LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1669246070
  Medicare reassignment
• Banner - University Hospital Based Physicians LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1538879481
  NPD
• Banner Cancer Center Specialists LLC

  • Oncology Clinic/Center
  • Payson, AZ
  • NPI 1588158448
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1780445171
  NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  NPD (past)
• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  NPD (past)
• Banner Ironwood Medical Center

  • General Acute Care Hospital
  • Queen Creek, AZ
  • NPI 1124341672
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation
• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Goldfield Medical Center

  • General Acute Care Hospital
  • Apache Junction, AZ
  • NPI 1932543428
  Care Compare affiliation
• Banner Heart Hospital

  • Special Hospital
  • Mesa, AZ
  • NPI 1215961248
  Care Compare affiliation
• Banner Ironwood Medical Center

  • General Acute Care Hospital
  • Queen Creek, AZ
  • NPI 1124341672
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1093158297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601232300",
            "telephone_number": "224-783-2525",
            "fax_number": "224-783-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD STE 3001A",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-657-5840",
            "fax_number": "847-657-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "CHARLOTTE",
        "middle_name": "HAERAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036139709",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036139709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena Marie Kolosieke, MOTR/L
• Christine Marie Komjathy, MS, RD, LDN
• Sumana Kondati, PTA
• Betty Kong
• Evelyn Konsur
• Katarzyna Koperska
• Michael James Korman
• Samantha Kornhauser, APN-CNP
• Miray Koro
• Gail M. Koshgarian, CNP

• Hospitalist Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.

Verify at the official NPI Registry.