DR. SU MIN KO M.D.
NPI 1336375450
Pain Medicine - Interventional Pain Medicine in Fairfax, VA

Active since June 03, 2009PECOS EnrolledAccepts Medicare Assignment
63.31/100
CMS Quality Rating
11166 FAIRFAX BLVD, SUITE 105, FAIRFAX, VA 22030(703) 277-3360(703) 277-3370 Get Directions Write a Review

NPPES record last updated: February 20, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Su Min Ko M.d. NPPES

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

DR. SU MIN KO M.D. (NPI 1336375450) is an individual interventional pain medicine provider in Fairfax, Virginia, licensed in Virginia (0101250991) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1336375450
Entity TypeIndividualMale
Primary Taxonomy208VP0014X
Provider Legal NameDR. SU MIN KOCredential: M.D.
Location Address11166 FAIRFAX BLVD, SUITE 105Fairfax, VA 22030-5017
Mailing Address11166 Fairfax Blvd, Suite 105Fairfax, VA 22030-5017 · (703) 277-3360 · Fax (703) 277-3370
Fax(703) 277-3370
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateJune 3, 2009
Last NPPES UpdateFebruary 20, 2017
NPI 1336375450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License Licensed in VA · 0101250991
Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License 2009001606 (MO)
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X · License 0101250991 (VA), 2009001606 (MO)
11166 FAIRFAX BLVD, Fairfax, VA 22030

Other Identifiers 15

Other98246MO · Hcusa
Other9496409MO · Aetna
Medicare PINMA11420007MO
Medicare PINMA2028004MO
Other2009001606MO · Medical License
Medicare PINMA1510007MO
Medicare PIN1580840006MO
Medicare PIN137740007MO
Medicaid1336375450MO
Medicare PINMA1140007MO
Medicare PINMA18310007MO
Medicare PIN1466660007MO
Other000000640716MO · Bcbs
Medicare PIN146640006MO
Medicare PINMA2027004MO

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Su Min Ko M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678627916
PECOS Enrollment IDI20121203000017, I20150430001588
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.

Areas of Expertise CMS Part B claims 30

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
2,146 services149 patients
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
1,001 services159 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
717 services239 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
209 services108 patients
Test for balance and posture 92548
A balance and posture test assesses your ability to maintain steady positioning and coordination. It involves simple tasks like standing on one foot or walking in a straight line. This helps identify any issues with your balance system, which can affect daily activities.
200 services200 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
197 services150 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22030 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

63.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality78.74
Promoting Interoperability0
Improvement Activities40

Reported Quality Measures

Documentation of Current Medications in the Medical Record
100%2,625 patients5/55-star benchmark: 100%
e-Prescribing
100%463 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
56%768 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
49%956 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
86%1,079 patients4/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
27%2,266 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 37% · 1,002 patients
Patients screened: 41% · 1,002 patients
5%43 patients1/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
45%303 patients2/55-star benchmark: 100%
Support Electronic Referral Loops By Sending Health Information
0%733 patients1/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 791 patients
Patients totalRate: 0% · 791 patients
0%791 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0642
DME-Orthotic Devices · category DF007N
2 suppliers62 claims62 services$253.48 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

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

In Home Supportive Care
11166 FAIRFAX BLVD
FAIRFAX, VA 22030
Non-emergency Medical Transport (VAN)
11166 FAIRFAX BLVD
FAIRFAX, VA 22030
Social Worker (Clinical)
11166 FAIRFAX BLVD
FAIRFAX, VA 22030
Physical Medicine & Rehabilitation (Pain Medicine)
11166 FAIRFAX BLVD, SUITE 105
FAIRFAX, VA 22030
Nurse Practitioner (Family)
11166 FAIRFAX BLVD, #105
FAIRFAX, VA 22030
Non-emergency Medical Transport (VAN)
11166 FAIRFAX BLVD
FAIRFAX, VA 22030
Non-emergency Medical Transport (VAN)
11166 FAIRFAX BLVD
FAIRFAX, VA 22030
Counselor (Mental Health)
11166 FAIRFAX BLVD, SUITE 500 #1075
FAIRFAX, VA 22030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Su Min Ko's NPI number?

The NPI number for Su Min Ko is 1336375450. It was assigned to this individual provider in the NPPES registry on June 3, 2009.

Where is Su Min Ko located?

Su Min Ko practices at 11166 Fairfax Blvd Suite 105, Fairfax, VA 22030. The listed phone number is (703) 277-3360.

What is Su Min Ko's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Su Min Ko enrolled in Medicare?

Yes. Su Min Ko is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Su Min Ko was last updated on February 20, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.