Individual provider Active NPI

Kyung Seo, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Baltimore, MD
National Provider Identifier
1467868257
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
01762 Issued in MD
Practice address
9105 Franklin Square Dr Ste 214
Baltimore, MD 21237-3934
Phone
(443) 777-7631
NPI assigned
Jul 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 308647 LA
Foot & Ankle Surgery Podiatrist 213ES0103X SC006590 PA
Foot & Ankle Surgery Podiatrist 213ES0103X 01762 MD Primary

Addresses

Primary practice location

9105 Franklin Square Dr Ste 214
Baltimore, MD 21237-3934

Mailing address

9105 Franklin Square Dr Ste 214
Baltimore, MD 21237-3934
Phone (443) 777-7631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181008003083 LA Practitioner - Podiatry 6507118213 Reassigns benefits to 1 organization
I20230913003476 MD Practitioner - Podiatry 6507118213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

9105 Franklin Square Dr
Baltimore, MD 21237-3930
Phone (443) 777-7785

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of tissue613
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01762MDMDFoot & Ankle Surgery Podiatrist
SC006590PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 22, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2023 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 22, 2018 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

2120 Driftwood Blvd
Kenner, LA 70065

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

1514 Jefferson Hwy
New Orleans, LA 70121

9105 Franklin Square Dr
Ste 214
Baltimore, MD 21237
Phone (410) 391-9144

12 Medstar Blvd
Ste 220
Bel Air, MD 21015
Phone (410) 877-8088

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

9105 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 574-1330

Organizations & group practices 5

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 2

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1467868257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 FRANKLIN SQUARE DR STE 214",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373934",
            "telephone_number": "443-777-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 FRANKLIN SQUARE DR STE 214",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373934",
            "telephone_number": "443-777-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "KYUNG",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "308647",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006590",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.