JESSE KO, MD, PLLC (NPI# 1518145366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518145366 |
| Entity Type | Organization |
| Organization Name | JESSE KO, MD, PLLC |
| Practice Address |
21008 Northern Blvd Suite 1a Bayside NY 11361-3211 |
| Practice Telephone | 7184237200 |
| Practice Fax Number | 7182248727 |
| Mailing Telephone | 7184237200 |
| Mailing Fax Number | 7182248727 |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-02-04 |
| Authorized Official Name | DR. JESSE KO (OWNER) |
| Authorized Official Telephone | 7184237200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 213571 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
21008 NORTHERN BLVD SUITE 1A |
| City | BAYSIDE |
| State | NY |
| Zip Code | 11361-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568447548 | Jill M Diamond | Audiologist | 21008 Northern Blvd, Suite 5, Bayside, NY 11361-3211 | 2005-12-13 |
| 1396384921 | Christina Ricciardi | Nurse Practitioner | 21008 Northern Blvd, Bayside, NY 11361-3211 | 2019-12-30 |
| 1578921904 | Kiarra Domenique Caneda Aldea | Physical Therapist | 21008 Northern Blvd, Ste 1, Bayside, NY 11361-3211 | 2016-01-30 |
| 1013314004 | Atom Physical Therapy PC | Specialist | 21008 Northern Blvd, Suite #1, Bayside, NY 11361-3211 | 2014-11-19 |
| 1083966170 | North Shore Medical Pllc | Internal Medicine | 21008 Northern Blvd, Suit 1a, Bayside, NY 11361-3211 | 2012-10-12 |
| 1558629899 | Pcl Hearing Services of New York, LLC | Specialist | 21008 Northern Blvd, Suite 5, Bayside, NY 11361-3211 | 2012-04-24 |
| 1356475990 | Lawrence J. Deutsch Phd, PC | Audiologist | 21008 Northern Blvd, Suite 5, Bayside, NY 11361-3211 | 2007-03-15 |
| 1427120526 | Fryer Dermatology, Pllc | Dermatology | 21008 Northern Blvd, Bayside, NY 11361-3211 | 2006-11-14 |
| 1467534610 | Kuai-hua Chiang | Physical Therapist | 21008 Northern Blvd, Ste #1, Bayside, NY 11361-3211 | 2006-10-19 |
| 1497856751 | Eric J Fryer | Dermatology | 21008 Northern Blvd, Bayside, NY 11361-3211 | 2006-09-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467078055 | Nicole E. Sarracco | Speech-Language Pathologist | 215 - 46 39th Avenue, Flushing, NY 11361 | 2020-06-19 |
| 1689294381 | Terri Robin Will | Registered Nurse | 3416 2019th Street, Queens, NY 11361 | 2020-04-22 |
| 1295364875 | Melanie Besthoff | Speech-Language Pathologist | 215-46 39th Avenue, Flushing, NY 11361 | 2020-04-05 |
| 1790339844 | Alana Valle | Occupational Therapist | 20947 34th Rd, Bayside, NY 11361 | 2019-07-26 |
| 1881175826 | Eva Mui | Pharmacist | 212 Northern Blvd, Bayside, NY 11361 | 2018-08-28 |
| 1063908531 | Hongik Acupuncture N.y. P.C. | Acupuncturist | 21441 42nd Ave Ste 4c, Bayside, NY 11361 | 2018-07-07 |
| 1093233694 | Karen Trentacosta | Registered Nurse | 40-04a Bell Boulevard, Bayside, NY 11361 | 2017-09-03 |
| 1801310131 | Hee Gi An | Dentist | 42-05 204th St, Flr 2, Bayside, NY 11361 | 2017-07-28 |
| 1780113050 | Miaoying Zhu | Social Worker | 217-63 Corbett Rd, Bayside, NY 11361 | 2017-06-08 |
| 1679016265 | Daniela Ragusa | Speech-Language Pathologist | 221-21 Corbett Road, Bayside, NY 11361 | 2016-11-30 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720565187 | Bayside Pediatrics PC | Pediatrics | 4223 212th St Ste 1b, Bayside, NY 11361-2987 | 2018-07-27 |
| 1932426921 | Eugene Deblasio | Pediatrics | 1414 Bonnie Ln, Bayside, NY 11360-1145 | 2010-04-29 |
| 1538351788 | Martin Poliskin | Pediatrics | 209-25 18th Avenue, Bayside, NY 11360 | 2007-08-13 |
| 1730220666 | Yohan Park | Pediatrics | 4223 212th St Unit 1b, Bayside, NY 11361-2979 | 2007-02-12 |
| 1427110253 | David Berman | Pediatrics | 4032 221st Street, Bayside, NY 11361-2429 | 2006-12-15 |
| 1992864698 | Linda Volpe | Pediatrics | 29-01 216 Street, Bayside, NY 11360-1138 | 2006-12-08 |
| 1972604189 | Grace Nunez-russotto | Pediatrics | 23 25 Bell Boulevard, Bayside, NY 11360 | 2006-09-26 |
| 1114024767 | Jonathan Horwitz | Pediatrics | 2325 Bell Blvd, Bayside, NY 11360-2056 | 2006-09-17 |
| 1497867121 | Carmencita Diaz-sy | Pediatrics | 21544 24th Ave, Bayside, NY 11360-2220 | 2006-08-31 |
| 1487661401 | Theodora Panteloglou | Pediatrics | 21430 46th Ave, Bayside, NY 11361-3316 | 2006-08-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.