Organization Active NPI

Angela Ko, MD PLLC

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1396315826
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANGELA KO, MD PLLC
Practice address
7600 N 15TH St Ste 290
Phoenix, AZ 85020-4336
Phone
(734) 945-5322
Fax
(602) 277-8146
NPI assigned
Jun 28, 2021
Last updated
Jul 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Authorized official

Name
Vanessa Koziol
Title
Credentialing Specialist
Phone
(480) 376-6456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

7600 N 15TH St Ste 290
Phoenix, AZ 85020-4336

Mailing address

8989 N Gainey Center Dr Unit 145
Scottsdale, AZ 85258-2114

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@eamedbill.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210715004403 AZ Part B Supplier - Clinic/Group Practice 6204238090 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1396315826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8989 N GAINEY CENTER DR UNIT 145",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852582114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204336",
            "telephone_number": "734-945-5322",
            "fax_number": "602-277-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA KO, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "480-376-6456"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@eamedbill.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "credentialing@eamedbill.com",
            "address_1": "8989 N Gainey Center Dr Unit 145",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852582114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.