Individual provider Active NPI

Angela Ko, OT

  • Occupational Therapist
  • Tacoma, WA
National Provider Identifier
1821648924
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60743091 Issued in WA
Practice address
1901 S 72ND St Ste a-1
Tacoma, WA 98408-1200
Phone
(253) 475-4870
Fax
(253) 475-4873
NPI assigned
Sep 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT60743091 WA Primary

Addresses

Primary practice location

1901 S 72ND St Ste a-1
Tacoma, WA 98408-1200

Mailing address

6050 Tacoma Mall Blvd Ste 300
Tacoma, WA 98409-6828
Phone (253) 581-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204002602 WA Practitioner - Occupational Therapist in Private Practice 3870926835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

6704 Tacoma Mall Blvd
Suite 100
Tacoma, WA 98409-9001
Phone (253) 475-4870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT60743091WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 1, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Occupational Therapist CurrentSince Oct 1, 2019 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

6050 Tacoma Mall Blvd
Ste 300
Tacoma, WA 98409
Phone (253) 851-5200

1901 S 72nd St
Ste A1
Tacoma, WA 98408
Phone (253) 475-4870

6704 Tacoma Mall Blvd
Ste 100
Tacoma, WA 98409
Phone (253) 475-4870

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": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1821648924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 TACOMA MALL BLVD STE 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096828",
            "telephone_number": "253-581-5200",
            "fax_number": "253-581-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S 72ND ST STE A-1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984081200",
            "telephone_number": "253-475-4870",
            "fax_number": "253-475-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "ANGELA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60743091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.