Andrew Lee-Wah Koo, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

14590 Issued in NH

Practice address

1 Medical Center Dr
Lebanon, NH 03756-0001

Phone

(603) 650-5000

NPI assigned

Sep 1, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in VT, NH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akoo532030@direct.dartmouth-hitchcock.org

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.

• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment NPD
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Medicare reassignment NPD
• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784

  Psychiatry

  Medicare reassignment NPD
• Central Vermont Medical Center Inc

  • Internal Medicine Physician
  • Berlin, VT
  • NPI 1831374362

  Psychiatry

  Medicare reassignment NPD
• Mary Hitchcock Memorial Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1699584219
  NPD

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1730281668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N MAIN ST",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 N Main St",
            "address_purpose": "LOCATION",
            "city": "White River Junction",
            "state": "VT",
            "postal_code": "050090001",
            "country_code": "US",
            "telephone_number": "802-295-9363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOO",
        "first_name": "ANDREW",
        "middle_name": "LEE-WAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NH",
            "license": "14590",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0011961",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VT",
            "license": "042-0011961",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017794",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Mohney Kolesar, PA
• Ben Raymond Kolker, MD
• Mahathi S Komaragiri, M.D.
• Brian Konefsky, OTR/L
• Alan Ted Kono, M.D.
• Antoinette Korc, M.D.
• Murray Korc, M.D.
• Anastas Kostojchin, MD
• Nishel Yogesh Kothari, M.B.B.S.
• Sai Kottapalli, MD

• Child & Adolescent Psychiatry Physician in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Child & Adolescent Psychiatry Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.