Rachel Koo

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

22998 Issued in NV

Practice address

Summerlin Hospital Medical Center
657 N Town Center Drive
Las Vegas, NV 89144

Phone

(702) 233-7499

Fax

(702) 233-7406

NPI assigned

Apr 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Loma Linda University School of Medicine, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Pokroy Medical Group of Nevada LTDGroup PAC ID 7911037643, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pokroy Medical Group of Nevada, LTD.

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
  • NPI 1992809412

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Summerlin Hospital Medical Center L L C

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831189638
  NPD (past)

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1225482532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUMMERLIN HOSPITAL MEDICAL CENTER",
            "address_2": "657 N TOWN CENTER DRIVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89144",
            "telephone_number": "702-233-7499",
            "fax_number": "702-233-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUMMERLIN HOSPITAL MEDICAL CENTER",
            "address_2": "657 N TOWN CENTER DRIVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89144",
            "telephone_number": "702-233-7499",
            "fax_number": "702-233-7406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2448 Dublin Way",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924084142",
            "country_code": "US",
            "telephone_number": "908-309-1780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOO",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A156243",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NV",
            "license": "22998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janal Hifumi Kono-Boelter, APRN
• Maximalian Alden Konrad
• Dean Kontoes
• Bibi S Koo, APRN
• Dominic Jung Soo Koo, PT
• Jahkiyle Kooimon
• Jerri Kooistra
• Song Bok Kook
• Koolmd
• Koolmd.Com

• Pediatric Critical Care Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatric Critical Care Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.