SOO H KO AGNP
NPI 1114673092
Nurse Practitioner - Gerontology in East Boston, MA

Q: What is Soo Ko's NPI number?

The NPI number for Soo Ko is 1114673092. It was assigned to this individual provider in the NPPES registry on March 1, 2022.

Q: What is Soo Ko's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Soo Ko was last updated on January 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 01, 2022PECOS Enrolled

10 GOVE ST, EAST BOSTON, MA 02128(617) 569-5899 Get Directions Write a Review

NPPES record last updated: January 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Soo H Ko Agnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOO H KO AGNP (NPI 1114673092) is an individual gerontology provider in East Boston, Massachusetts, licensed in Massachusetts (RN2326883) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114673092

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameSOO H KOCredential: AGNP

Location Address10 GOVE STEast Boston, MA 02128-1931

Mailing Address10 Gove StEast Boston, MA 02128-1931 · (617) 569-5899

Phone(617) 569-5899

Sole ProprietorNo

Enumeration DateMarch 1, 2022

Last NPPES UpdateJanuary 19, 2024

NPPES CertifiedJanuary 19, 2024

✔ NPI 1114673092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MA · RN2326883

Also ListedRegistered NurseTaxonomy 163W00000X · License RN2326883 (MA)

10 GOVE ST, East Boston, MA 02128

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Soo H Ko Agnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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