Michelle Koo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA2705 Issued in MD

Practice address

45485 Miramar Way
California, MD 20619-3191

Phone

(240) 434-1907

NPI assigned

Aug 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dr Anup K Panjwani and Associates Inc

  • Optometrist
  • Alexandria, VA
  • NPI 1275827982

  MD

  Medicare reassignment NPD
• Warrenton Eye Center LLC

  • Optometrist
  • Warrenton, VA
  • NPI 1871846188
  NPD (past)

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1467930479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45485 MIRAMAR WAY",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193191",
            "telephone_number": "240-434-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45485 MIRAMAR WAY",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193191",
            "telephone_number": "240-434-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "MICHELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beena Khetpal
• Britney Marie King, CRNP
• Erin King
• Kendra King, SLPA
• Jordan Kinney
• Christopher Matthew Koterwas, D.D.S.
• Chandrasekhar Kothuru, MD
• Michael Jeffrey Kuhn, D.D.S.
• Megan Labrack
• Oluwagbolahan Oladipo Lagoke, PHARM D

• Optometrist in California, MD
• Providers in California, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.