Je Deuk Ko, M.D. PH.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

179040 Issued in CA

Practice address

10921 Wilshire Blvd Ste 409B
Los Angeles, CA 90024-4001

Phone

(310) 922-0584

NPI assigned

Jun 27, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, CA2 enrollments

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 2

Specialty

Psychiatry

Education

Saint Louis University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: je.ko@706997947596804.direct.elationemr.com

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.

• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909

  Psychiatry

  Medicare reassignment Care Compare group NPD
• JKC Neurology Medical Group Inc

  • Specialist
  • Los Angeles, CA
  • NPI 1720536923
  Medicare reassignment NPD
• Med Forte Medical Group

  • Primary Care Clinic/Center
  • Lynwood, CA
  • NPI 1154059749
  Medicare reassignment NPD
• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123
  Medicare reassignment NPD
• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573

  Psychiatry

  Medicare reassignment NPD
• The Commonwealth of Massachusetts

  • Long Term Care Hospital
  • Tewksbury, MA
  • NPI 1871680496
  Medicare reassignment NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  CA, Psychiatry

  Medicare reassignment NPD
• The Commonwealth of Massachusetts

  • General Acute Care Hospital
  • Holyoke, MA
  • NPI 1427111574
  NPD
• Umass Memorial Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1356792758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9736 YOAKUM DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902101436",
            "telephone_number": "310-922-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 409B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244001",
            "telephone_number": "310-922-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "JE",
        "middle_name": "DEUK",
        "name_prefix": "Dr.",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "278739",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A179040",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "278739",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2016021108",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "179040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Han Ho Ko, RPH
• Hetty Ko, CRNA
• Jaemin Ko, DDS
• James Ko
• Jamie Ko
• Jeffrey Kuan-Yu Ko, LCSW
• Jennifer Ko
• Jin Wook Ko, L.AC.
• Joan Soyoung Ko, M.D.
• Joyce Ko

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.