| Phillip J Koo, MD | |
|
12605 E 16th Ave, Aurora, CO 80045-2545 | |
| (720) 848-0000 | |
| Not Available |
| Full Name | Phillip J Koo |
|---|---|
| Gender | Male |
| Speciality | Nuclear Medicine |
| Experience | 20 Years |
| Location | 12605 E 16th Ave, Aurora, Colorado |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306902259 | NPI | - | NPPES |
| 06234011 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MT186002 (Pennsylvania) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 49688 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Banner Gateway Medical Center | Gilbert, AZ | Hospital |
| Banner Boswell Medical Center | Sun city, AZ | Hospital |
| Banner - University Medical Center Phoenix | Phoenix, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Banner Imaging Services Llc | 1850724386 | 112 |
| Banner Hospital Based Physicians Arizona Llc | 3274782487 | 524 |
| Banner Cancer Center Specialists Llc | 6103097779 | 281 |
| Entity Name | Banner Cancer Center Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518253152 PECOS PAC ID: 6103097779 Enrollment ID: O20110913000224 |
| Entity Name | Banner Hospital Based Physicians Arizona Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275889891 PECOS PAC ID: 3274782487 Enrollment ID: O20121003000752 |
| Entity Name | Banner - University Hospital Based Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750751566 PECOS PAC ID: 1052614294 Enrollment ID: O20160122000508 |
| Entity Name | Banner Imaging Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770139958 PECOS PAC ID: 1850724386 Enrollment ID: O20191213001312 |
| Mailing Address | Practice Location Address |
|---|---|
| Phillip J Koo, MD Po Box 110429, Aurora, CO 80042-0429 Ph: (303) 493-7000 | Phillip J Koo, MD 12605 E 16th Ave, Aurora, CO 80045-2545 Ph: (720) 848-0000 |
Dr. Tyler Robin, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1665 Aurora Ct, Suite 1032, Msf706, Aurora, CO 80045 Phone: 720-848-0100 | |
Rodrigo Canellas De Souza, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12605 E 16th Ave, Aurora, CO 80045 Phone: 720-848-0000 | |
Dr. Ryan Michael Lanning, M.D., PHD. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1665 Aurora Ct, Suite 1032, Aurora, CO 80045 Phone: 720-848-0100 Fax: 720-848-0113 | |
Stephanie C Hsu, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 13123 E 16th Ave, Aurora, CO 80045 Phone: 720-777-1234 | |
Thomas Suby-long, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 12605 E 16th Ave, Aurora, CO 80045 Phone: 720-848-0000 | |
Alan E Evans, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 12605 E 16th Ave, Aurora, CO 80045 Phone: 720-848-0000 | |
Laura Acosta Izquierdo, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 13123 E 16th Ave, Aurora, CO 80045 Phone: 720-777-8509 |