Injung Ko, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F310572 Issued in NY

Practice address

21102 73Rd Ave
Bayside, NY 11364-2855

Phone

(347) 421-4789

NPI assigned

Nov 15, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Choice Medical PCGroup PAC ID 1759636491, 5 clinicians

Physiatry Consultants of NJ LLCGroup PAC ID 3375914419, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: iko843461@nychhc.direct-ci.com

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.

• Clear Choice Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1285155499
  Medicare reassignment Care Compare group NPD
• Physiatry Consultants of NJ LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1710690631

  NJ

  Medicare reassignment Care Compare group NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• Ilm Medical Care PLLC

  • Specialist
  • Brooklyn, NY
  • NPI 1023442035
  Medicare reassignment NPD
• Silver Star Medical Association of NJ PC

  • Internal Medicine Physician
  • Upper Saddle River, NJ
  • NPI 1710677091

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1720744766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211-2 73RD AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "347-421-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21102 73RD AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113642855",
            "telephone_number": "347-421-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "INJUNG",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia Klotsos, P.T.
• Knickerbocker Dialysis Inc
• Ira Knobler
• Emily Faith Ko
• Esther Ko
• Jesse Ko, M.D.
• Stanley G Ko
• Richard Wallace Koffler, CASAC
• Omid Kohani, MD
• Michael Kokolis, DDS

• Adult Health Nurse Practitioner in Bayside, NY
• Providers in Bayside, NY by specialty
• Adult Health Nurse Practitioner in New York

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