Individual provider Active NPI

Phillip J. Koo, MD

  • Diagnostic Radiology Physician
  • Aurora, CO
National Provider Identifier
1306902259
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
49688 Issued in CO
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT186002 PA
Diagnostic Radiology Physician 2085R0202X 49688 CO Primary

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Other identifiers 1

IdentifierTypeStateIssuer
06234011MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20160823003107 AZ Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 5799956983 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Diagnostic Radiology
Education
Drexel University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians
Banner Cancer Center Specialists LLCGroup PAC ID 6103097779, 343 clinicians
Banner Imaging Services LLCGroup PAC ID 1850724386, 122 clinicians

Practice addresses (Care Compare)

1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (480) 453-2034

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

5605 W Eugie Ave
Suite 110
Glendale, AZ 85304-1273
Phone (480) 610-7400

Hospital & facility affiliations

  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061
  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49688COMDDiagnostic Radiology Physician
MT186002PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Imaging Services LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Aug 1, 2016 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 14, 2016 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Oct 1, 2022 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 14, 2016 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Oct 1, 2022 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Aug 1, 2016 Accepting new patients

Locations (25 of 33)

1828 E Florence Blvd
Ste 118
Casa Grande, AZ 85122
Phone (520) 381-9729

1125 S Alma School Rd
Ste 110
Chandler, AZ 85286

1076 W Chandler Blvd
Ste 120
Chandler, AZ 85224
Phone (480) 821-9198

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

665 N Gilbert Rd
Ste 154
Gilbert, AZ 85234
Phone (480) 507-4500

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

5605 W Eugie Ave
Ste 110
Glendale, AZ 85304
Phone (602) 938-2002

5601 W Eugie Ave
Ste 102
Glendale, AZ 85304
Phone (602) 588-3420

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

7701 W Aspera Blvd
Ste 101
Glendale, AZ 85308
Phone (623) 248-2100

5757 W Thunderbird Rd
Ste W100ANDW101
Glendale, AZ 85306

1800 N Civic Sq
Ste 120
Goodyear, AZ 85395
Phone (928) 813-4624

6424 E Broadway Rd
Ste 101
Mesa, AZ 85206
Phone (602) 830-0619

1450 S Dobson Rd
Ste A100
Mesa, AZ 85202
Phone (480) 545-9779

6553 E Baywood Ave
Ste 102
Mesa, AZ 85206
Phone (480) 268-7600

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

13640 N Plaza del Rio Blvd
Ste 105
Peoria, AZ 85381

2222 E Highland Ave
Ste 106
Phoenix, AZ 85016
Phone (602) 483-6165

9305 W Thomas Rd
Ste 100AND200
Phoenix, AZ 85037

9305 W Thomas Rd
Ste 100
Phoenix, AZ 85037
Phone (623) 842-5652

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

16641 N 40th St
Ste 1
Phoenix, AZ 85032
Phone (623) 931-7999

4200 E Camelback Rd
Ste 105
Phoenix, AZ 85018

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1306902259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "PHILLIP",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT186002",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "49688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06234011",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.