Individual provider Active NPI

Betty Kuo, PA-C

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1194591156
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
031014 Issued in NY
Practice address
821 45TH St Ste 101
Brooklyn, NY 11220-5286
Phone
(718) 972-1233
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 031014 NY Primary

Addresses

Primary practice location

821 45TH St Ste 101
Brooklyn, NY 11220-5286

Mailing address

151 E 3Rd St Apt 2a
New York, NY 10009-7423
Phone (408) 775-5593

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626000299 NY Practitioner - Physician Assistant 2668945007

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 Kelby St
FL 9
Fort Lee, NJ 07024-2939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
031014NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Medical Service, LLC CurrentSince Dec 3, 2023 Accepting new patients
Kings Physician Services, PC PastSince Dec 3, 2023 Accepting new patients

Locations

821 45th St
Ste 101
Brooklyn, NY 11220
Phone (718) 972-1233

4506 8th Ave
Brooklyn, NY 11220
Phone (718) 972-1233

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1194591156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E 3RD ST APT 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097423",
            "telephone_number": "408-775-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 45TH ST STE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205286",
            "telephone_number": "718-972-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "BETTY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "031014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.