Active NPI
Peter Y. Ko, MD
- Family Medicine Physician
- Flushing, NY
National Provider Identifier
1154415461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 118242
- Practice address
- 14307 Sanford Ave
Flushing, NY 11355-2046 - Phone
- (718) 539-5400
- Fax
- (718) 539-5190
- NPI assigned
- Oct 3, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 118242 | NY | Primary |
Addresses
Primary practice location
14307 Sanford Ave
Flushing, NY 11355-2046
Mailing address
14307 Sanford Ave
Flushing, NY 11355-2046
Phone (718) 539-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040920000132 | NY | Practitioner - Family Practice | 7719955616 | Practice locations: Flushing, NY; Bayside, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
14307 Sanford Ave
Apt 1D
Flushing, NY 11355-2001
Phone (718) 539-5400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118242 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1154415461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14307 SANFORD AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113552046",
"telephone_number": "718-539-5400",
"fax_number": "718-539-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14307 SANFORD AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113552046",
"telephone_number": "718-539-5400",
"fax_number": "718-539-5190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KO",
"first_name": "PETER",
"middle_name": "Y.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "118242",
"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 Dec 21, 2010; 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.