Kristin L. Koo, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN2362061 Issued in MA

Practice address

850 Harrison Ave, FL 4
Yawkey BLDG
Boston, MA 02118

Phone

(617) 414-2000

Fax

(617) 414-5798

NPI assigned

Nov 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kristin Lee Koo Other name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkoo171054@direct.bmc.masshiway.net
• Direct secure messaging: kkoo32971@direct.neighborhealth.masshiway.net
• FHIR API: https://api.platform.athenahealth.com/2126/brand/1/csg/1/fhir/r4

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.

• Boston University Obstetrics and Gynecology Foundation, Inc.

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1063459568
  Medicare reassignment NPD
• Internal Medical Associates-Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1558481879
  Medicare reassignment NPD
• Neighborhealth Corporation

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1316994411
  Medicare reassignment NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Medical Associates of Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1255451597
  NPD
• Women'S Specialists of Bucks County, P.C.

  • Obstetrics & Gynecology Physician
  • Langhorne, PA
  • NPI 1700978228
  NPD (past)

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1588200042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE, FL 4",
            "address_2": "YAWKEY BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Albany St, FL 5",
            "address_2": "Shapiro Bldg",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOO",
        "first_name": "KRISTIN",
        "middle_name": "L.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR20043600",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00070100",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2362061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110185546A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KOO",
            "middle_name": "LEE",
            "credential": "CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daryl Konstandt
• Yuval Konstantino, MD
• Panagiotis Konstantinopoulos, M.D.
• Jessica L Konter, PT
• Nicole Lisa Kontos, PHD
• Siulam Ciel Koo, D.O.
• Sophia Koo, M.D.
• Sebastian Hassan John Koochaki, MD, PHD
• Gerald Paul Koocher, PH.D.
• Tristan Gregory Kooistra, M.D.

• Advanced Practice Midwife in Boston, MA
• Providers in Boston, MA by specialty
• Advanced Practice Midwife in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.