Wilson Ko, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

158635 Issued in NY

Practice address

13625 Maple Ave
Suite 202
Flushing, NY 11355-3870

Phone

(718) 358-5900

Fax

(718) 463-8049

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

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

Ophthalmology

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilson Ko MD Facs PCGroup PAC ID 1456442789, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wilson Ko, M.D., F.a.C.S., P.C.

  • Ophthalmologic Surgery Clinic/Center
  • Flushing, NY
  • NPI 1437365665
  Medicare reassignment Care Compare group NPD Authorized official
• Ophthalmology Surgical Associates PLLC

  • Ophthalmology Physician
  • New York, NY
  • NPI 1558541177
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1770560096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 MAPLE AVE",
            "address_2": "SUITE 202",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553870",
            "telephone_number": "718-358-5900",
            "fax_number": "718-463-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 MAPLE AVE",
            "address_2": "SUITE 202",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553870",
            "telephone_number": "718-358-5900",
            "fax_number": "718-463-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "WILSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "158635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER PLAN",
            "identifier": "160517",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHILED",
            "identifier": "20E801",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01067050",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NS2922",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Y. Ko, MD
• Sungmin Ko
• Taeho Ko
• Tommy Ko
• Wan Yao Amanda Ko, MSOTR/L
• Koam Dental, PC
• Koam Medical Service P.C.
• Koam Physical Therapy, P.C.
• Liat Kobaivanov
• Chaya Lieba Kobernick, PSYD

• Ophthalmology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.