Active NPI
Derrick Ko, OTR/L, CO
- Occupational Therapist
- Flushing, NY
National Provider Identifier
1124374988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 017182
- Practice address
- 142-60 56TH Rd.
Flushing, NY 11355 - Phone
- (646) 250-6429
- NPI assigned
- Jul 31, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CO003271 | NY | |
| Occupational Therapist | 225X00000X | 017182 | NY | Primary |
Addresses
Primary practice location
142-60 56TH Rd.
Flushing, NY 11355
Mailing address
142-60 56TH Rd.
Flushing, NY 11355
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 |
|---|---|---|---|
| CO003271 | NY | MD | Orthotist |
| 017182 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1124374988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142-60 56TH RD.",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142-60 56TH RD.",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11355",
"telephone_number": "646-250-6429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KO",
"first_name": "DERRICK",
"name_prefix": "Mr.",
"credential": "OTR/L, CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-31",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "NY",
"license": "CO003271",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "017182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.