Individual provider Active NPI

Raymond Koo

  • Pharmacist
  • Flushing, NY
National Provider Identifier
1801442736
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
065651 Issued in NY
Practice address
13693 Roosevelt Ave
Flushing, NY 11354-5521
Phone
(917) 586-3878
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 065651 NY Primary

Addresses

Primary practice location

13693 Roosevelt Ave
Flushing, NY 11354-5521

Mailing address

13693 Roosevelt Ave
Flushing, NY 11354-5521
Phone (917) 586-3878

Other practice location 1

750 6th Ave
New York, NY 10010
Phone (646) 336-8388

Other practice location 2

1060 71st St
Brooklyn, NY 11228-1215
Phone (917) 586-3878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
065651NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
RX Express Pharmacy Inc. CurrentSince Apr 27, 2025 Accepting new patients
CVS Albany LLC PastSince Nov 1, 2019 Accepting new patients
CVS Albany LLC PastSince Nov 1, 2019 Accepting new patients

Locations

13693 Roosevelt Ave
Flushing, NY 11354
Phone (718) 353-4055

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1801442736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13693 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545521",
            "telephone_number": "917-586-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13693 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545521",
            "telephone_number": "917-586-3878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 6th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10010",
            "country_code": "US",
            "telephone_number": "646-336-8388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1060 71st St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112281215",
            "country_code": "US",
            "telephone_number": "917-586-3878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOO",
        "first_name": "RAYMOND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "065651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.