Martha Brewer Koo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G78080 Issued in CA

Practice address

2615 Pacific Coast Hwy
#215
Hermosa Beach, CA 90254-2225

Phone

(310) 318-2566

NPI assigned

Feb 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 2, 2017 through Nov 2, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Martha B. Koo, M.D., LTD.

  • Adult Mental Health Clinic/Center
  • Hermosa Beach, CA
  • NPI 1487848404
  NPD (past) Authorized official
• South Bay TMS Therapy Center

  • Mental Health Counselor
  • Manhattan Beach, CA
  • NPI 1811442767
  NPD (past) Authorized official
• Neuro Wellness Spa, a Medical PC

  • Psychiatry Physician
  • Manhattan Beach, CA
  • NPI 1003394149
  NPD

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1497899728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 LARSSON ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666734",
            "telephone_number": "310-318-2566",
            "fax_number": "310-318-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 PACIFIC COAST HWY",
            "address_2": "#215",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542225",
            "telephone_number": "310-318-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "MARTHA",
        "middle_name": "BREWER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "G78080",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G78080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Leeanne Klein, MA
• Mary Elizabeth Klem, MFT
• KMS Group Inc
• Stacy Lynn Knupfer, LMFT
• Dyana Ko, NP
• Christina Marie Kowan
• Lacy Kuester, RDN
• La Lactation, LLC
• Fabiana C Lahmon, RD
• Tianfu Lam

• Psychiatry Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.