Individual provider Active NPI

Ki-Hyuk Yoo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Dorchester, MA
National Provider Identifier
1881906626
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MA2398 Issued in MA
Practice address
2110 Dorchester Ave Ste 203
Dorchester, MA 02124
Phone
(617) 696-5355
Fax
(617) 696-5357
NPI assigned
Jul 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X MA2398 MA Primary

Addresses

Primary practice location

2110 Dorchester Ave Ste 203
Dorchester, MA 02124

Mailing address

2110 Dorchester Ave Ste 203
Dorchester, MA 02124-5699
Phone (617) 696-5355

Other practice location 1

2110 Dorchester Ave Ste 203
Dorchester, MA 02124
Phone (617) 696-5355

Other identifiers 1

IdentifierTypeStateIssuer
110099331AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140402002184 MA Practitioner - Podiatry 4183855232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Redfield St
Suite 301
Dorchester, MA 02122-3651
Phone (617) 696-5355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue562
Removal of skin lesions11
Removal of nail tissue1181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MA2398MAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Yoo Foot and Ankle Podiatry, LLC. Foot & Ankle Surgery CurrentSince Mar 13, 2017 Accepting new patients
Harbor Health Services, Inc. CurrentSince Feb 15, 2015 Accepting new patients
Harbor Health Services, Inc. CurrentSince Feb 15, 2015 Accepting new patients

Locations

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

50 Redfield St
Ste 301
Dorchester, MA 02122
Phone (617) 288-7450

2110 Dorchester Ave
Ste 203
Dorchestr Ctr, MA 02124
Phone (617) 296-4951

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15451/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ki-hyuk.yoo.1@15451.direct.athenahealth.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1881906626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 DORCHESTER AVE STE 203",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245699",
            "telephone_number": "617-696-5355",
            "fax_number": "617-696-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 DORCHESTER AVE STE 203",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "617-696-5355",
            "fax_number": "617-696-5357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2110 Dorchester Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "02124",
            "country_code": "US",
            "telephone_number": "617-696-5355",
            "fax_number": "617-696-5357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOO",
        "first_name": "KI-HYUK",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "MA2398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110099331A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.