Individual provider Active NPI

Brian Koo, M.D.

  • Neurology Physician
  • Cleveland, OH
National Provider Identifier
1346435930
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
52133 Issued in CT
Practice address
11100 Euclid Ave
Cleveland, OH 44106
Phone
(216) 286-6260
NPI assigned
Sep 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 52133 CT Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106

Mailing address

PO Box 208018
New Haven, CT 06520-8018

Other identifiers 2

IdentifierTypeStateIssuer
2849716MedicaidOH
P00743380OtherOHMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkoo225487@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20130909000069 CT Practitioner - NeurologyPractitioner - Sleep Medicine 3476625344 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Sleep Medicine
Education
Tufts University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Prospect CT Medical Foundation, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Yale University CurrentSince Aug 1, 2013 Accepting new patients
State of Connecticut CurrentSince Dec 16, 2024 Accepting new patients
Yale University CurrentSince Aug 1, 2013 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Yale University Neurology Current Accepting new patients
State of Connecticut CurrentSince Dec 16, 2024 Accepting new patients
University Primary Care Practices Inc Neurology Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

165 Capitol Ave
Ste 2000
Hartford, CT 06106

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1579 Straits Tpke
Ste 2A
Middlebury, CT 06762
Phone (203) 754-3631

1625 Straits Tpke
Ste 307
Middlebury, CT 06762
Phone (203) 758-2635

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

Interoperability endpoints

  • Direct secure messaging: bkoo130940@direct.ynhh.org

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 6

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": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1346435930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208018",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-286-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-07",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "52133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2849716",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00743380",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkoo225487@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1625 Straits Tpke Ste 307",
            "city": "Middlebury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067621836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.