NPIMap

Organization Active NPI

Ko Medical Rehabilitation, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Plainview, NY
National Provider Identifier
1679324438
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
KO MEDICAL REHABILITATION, PLLC
Practice address
888 Old Country Rd
Plainview, NY 11803-4914
Phone
(718) 598-6808
Fax
(770) 502-6792
NPI assigned
Mar 29, 2024
Last updated
Aug 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Kunal Oak, DONPI 1578983102
Title
Owner
Phone
(718) 598-6808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU Primary

Addresses

Primary practice location

888 Old Country Rd
Plainview, NY 11803-4914

Mailing address

43 Narcissus Dr
Syosset, NY 11791-2820
Phone (718) 598-6808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240520003677 NY Part B Supplier - Clinic/Group Practice 8224470463 Receives reassigned benefits from 8 practitioners
Practice locations: Syosset, NY; Woodbury, NY; West Babylon, NY; Southampton, NY; Port Jefferson Station, NY; Medford, NY; Jamaica, NY; Great Neck, NY…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1679324438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 NARCISSUS DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117912820",
            "telephone_number": "718-598-6808",
            "fax_number": "770-502-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034914",
            "telephone_number": "718-598-6808",
            "fax_number": "770-502-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KO MEDICAL REHABILITATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "OAK",
        "authorized_official_first_name": "KUNAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-598-6808",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.