Annie Ko, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD60818213 Issued in WA

Practice address

1304 Fawcett Ave Ste 100
Tacoma, WA 98402

Phone

(253) 761-4200

Fax

(253) 761-4201

NPI assigned

Mar 22, 2012

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

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Saint Louis University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Permanente Central Hospital Hospital, Seattle, WA, CCN 500052

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ako4253352@ghc.direct-ci.net

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1083802946
  Medicare reassignment NPD
• Tra-Minw P S

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1396814166
  Medicare reassignment NPD
• Union Avenue Open MRI LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1568531242
  Medicare reassignment NPD
• The Carol Milgard Breast Center

  • Mammography Clinic/Center
  • Tacoma, WA
  • NPI 1063661098
  Medicare reassignment
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701

  Hospital

  Care Compare affiliation
• Kaiser Foundation Health Plan of Washington

  • General Acute Care Hospital
  • Redmond, WA
  • NPI 1609906825
  Care Compare affiliation
• Kaiser Foundation Health Plan of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1861522088
  Care Compare affiliation

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1679849756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011535",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98402",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 15th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723754",
            "country_code": "US",
            "telephone_number": "253-841-4353",
            "fax_number": "253-583-8630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2502 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051328",
            "country_code": "US",
            "telephone_number": "253-761-9482",
            "fax_number": "253-759-6252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "209 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054265",
            "country_code": "US",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KO",
        "first_name": "ANNIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60818213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-DINW",
            "identifier": "0387743",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2097121",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-UAOM",
            "identifier": "0387742",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA REST OF WA",
            "identifier": "0387737",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA KING COUNTY",
            "identifier": "0387739",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Spencer Rommel Knudson, PHARMD
• Gene C Knutson, DMP
• Tristan L Knutson, M.D.
• Alice Ko, DMD
• Angela Ko, OT
• Raymond Ko, MD
• Sang Chul Ko, LMP
• Yeoun Ko
• Janet Kobayashi-Hobson, CCC
• Amanda Sanae Mei Lin Kobayashi, DDS

• Diagnostic Radiology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.