Bon Chul Koo, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35043277 Issued in OH

Practice address

4853 Galaxy Pkwy
Suite I
Cleveland, OH 44128-5973

Phone

(216) 831-9786

Fax

(216) 831-2425

NPI assigned

Aug 25, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• DRS. Hill & Thomas Co.

  • Radiology Clinic/Center
  • Medina, OH
  • NPI 1265544662
  NPD (past)

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1205829280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4853 GALAXY PKWY",
            "address_2": "SUITE I",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441285973",
            "telephone_number": "216-831-9786",
            "fax_number": "216-831-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4853 GALAXY PKWY",
            "address_2": "SUITE I",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441285973",
            "telephone_number": "216-831-9786",
            "fax_number": "216-831-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "BON",
        "middle_name": "CHUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35043277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0404075",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dimitri Kontoveros, PHARMD
• Genevieve Ruth Kontra
• Jalayn Konys
• Kara Konys
• Anna P Koo, MD
• Brian Koo, M.D.
• Gloria J Koomson, M.D
• Henry B Koon Jr., MD
• Christopher Koons, MD
• Karen L. Kopan, APN-CNP

• Diagnostic Radiology Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.