Individual provider Active NPI

Paul Kyung Cho, NP

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1487374773
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1210331 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-1100
NPI assigned
Aug 29, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95021731 CA
Acute Care Nurse Practitioner 363LA2100X 1210331 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

1428 Oakhorne Dr
Harbor City, CA 90710-1137
Phone (213) 434-9155

Other practice location 1

1428 Oakhorne Dr
Harbor City, CA 90710-1137
Phone (213) 434-9155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, CO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230209001818 CA Practitioner - Nurse Practitioner 0941672448 Reassigns benefits to 2 organizations
I20251211004121 TX Practitioner - Nurse Practitioner 0941672448 Reassigns benefits to 1 organization
I20260209001716 CO Practitioner - Nurse Practitioner 0941672448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

2500 Rocky Mountain Ave
Loveland, CO 80538-9004
Phone (970) 624-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95021731CAMDAcute Care Nurse Practitioner
1210331TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Multi-Specialty Center Inc CurrentSince Jan 16, 2022 Accepting new patients
Southern California Multi-Specialty Center Inc CurrentSince Jan 16, 2022 Accepting new patients
California Wound Healing Medical Group Inc. CurrentSince Jan 6, 2023 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 15, 2026 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Dec 3, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

19950 Rinaldi St
Ste 101D
Porter Ranch, CA 91326
Phone (818) 488-5188

18345 Ventura Blvd
Ste 510
Tarzana, CA 91356
Phone (818) 757-7600

26357 McBean Pkwy
Ste 255
Valencia, CA 91355
Phone (661) 255-1515

5805 Sepulveda Blvd
Ste 690
Van Nuys, CA 91411
Phone (818) 900-6480

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

2500 Rocky Mountain Ave
Ste 360
Loveland, CO 80538
Phone (970) 221-5878

2500 Rocky Mountain Ave
Ste 340
Loveland, CO 80538
Phone (970) 221-5878

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1500 S Main St
Fl 2
Ft Worth, TX 76104
Phone (817) 702-3000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1487374773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 OAKHORNE DR",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907101137",
            "telephone_number": "213-434-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1428 Oakhorne Dr",
            "address_purpose": "LOCATION",
            "city": "Harbor City",
            "state": "CA",
            "postal_code": "907101137",
            "country_code": "US",
            "telephone_number": "213-434-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHO",
        "first_name": "PAUL",
        "middle_name": "KYUNG",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95021731",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1210331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.