Timothy Allen Ko, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

013607 Issued in NY

Practice address

739 Irving Ave
Suite 600
Syracuse, NY 13210-1651

Phone

(315) 701-2550

Fax

(315) 701-2551

NPI assigned

Oct 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middle Tennessee Surgical Specialists, LLCGroup PAC ID 9133014707, 9 clinicians

Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059
• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothyko@oswegohealth.hiemail.healtheconnections.org

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.

• Crouse Medical Practice, PLLC

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1922321934
  Medicare reassignment Care Compare group NPD
• Middle Tennessee Surgical Specialists, LLC

  • Specialist
  • Cookeville, TN
  • NPI 1134212640
  Medicare reassignment Care Compare group NPD
• Crouse Medical Practice PLLC

  • Clinical Medical Laboratory
  • Syracuse, NY
  • NPI 1548579212
  NPD (past)

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

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation
• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1164757258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1466",
            "fax_number": "315-470-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 600",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101651",
            "telephone_number": "315-701-2550",
            "fax_number": "315-701-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "TIMOTHY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tko@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave",
            "address_2": "Suite 600",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen J Knohl, MD
• Andrew Knoll, M.D.
• James L Knoll, M.D.
• Jessica Anne Knox, PT
• Brenda Ko, PT, RN
• Hazar Kobayaa, M.D.
• Katsuhiro Kobayashi, M.D.
• Amanda Kobus, MA, RD, CDN
• Carolyn Bradley Koch, M.A., L.M.H.C.
• Jacqueline Koch

• Physician Assistant in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.