DR. SU MIN KO M.D. NPI 1336375450

NPI Information

  • NPI: 1336375450
  • Provider Name: DR. SU MIN KO, M.D.
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11166 FAIRFAX BLVD
    SUITE 105
    FAIRFAX, VA
    ZIP 22030
  • Phone: (703) 277-3360

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NPI Details

DR. Su Min Ko, M.D. is an interventional pain medicine pain medicine in Fairfax, VA with 30 years of experience. The provider is 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. DR. Su Min Ko, M.D. NPI is 1336375450. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11166 FAIRFAX BLVD
SUITE 105
FAIRFAX, VA
ZIP 22030-017
Phone: (703) 277-3360
Fax: (703) 277-3370

The NPI 1336375450 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • Telephone medical discussion with physician, 11-20 minutes (HCPCS:99442)
  • Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Test for balance and posture (HCPCS:92548)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level (HCPCS:64484)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Telephone medical discussion with physician, 5-10 minutes (HCPCS:99441)
  • Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg (HCPCS:J3420)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Injection, methylprednisolone acetate, 80 mg (HCPCS:J1040)
  • Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose (HCPCS:J7324)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Injection of lower or sacral spine facet joint using imaging guidance, second level (HCPCS:64494)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Testing for presence of drug, read by direct observation (HCPCS:80305)
  • Ultrasonic guidance for needle placement (HCPCS:76942)
  • Fluoroscopic guidance for needle placement (HCPCS:77002)
  • Injection into tendon or ligament (HCPCS:20550)
  • Telephone medical discussion with physician, 21-30 minutes (HCPCS:99443)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64636)
  • Aspiration and/or injection of fluid large joint using ultrasound guidance (HCPCS:20611)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
  • Injection of trigger points, 3 or more muscles (HCPCS:20553)
  • Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance (HCPCS:27096)
  • Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
  • Injection of upper or middle spine facet joint using imaging guidance, second level (HCPCS:64491)
  • Aspiration and/or injection of fluid from small joint using ultrasound guidance (HCPCS:20604)
  • Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64634)
  • Aspiration and/or injection of fluid from medium joint using ultrasound guidance (HCPCS:20606)
  • Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64633)

The enumeration date for this NPI number is 6/3/2009 and was last updated on 2/20/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & Rehabilitation2009001606MISSOURINo
22081P2900XPhysical Medicine & RehabilitationPain Medicine0101250991VIRGINIANo
32081P2900XPhysical Medicine & RehabilitationPain Medicine2009001606MISSOURINo
4208VP0014XPain MedicineInterventional Pain Medicine0101250991VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
198246OTHERMISSOURIHCUSA
29496409OTHERMISSOURIAETNA
3MA11420007MEDICARE PINMISSOURI
4MA2028004MEDICARE PINMISSOURI
52009001606OTHERMISSOURIMEDICAL LICENSE
6MA1510007MEDICARE PINMISSOURI
71580840006MEDICARE PINMISSOURI
8137740007MEDICARE PINMISSOURI
91336375450MEDICAIDMISSOURI
10MA1140007MEDICARE PINMISSOURI
11MA18310007MEDICARE PINMISSOURI
121466660007MEDICARE PINMISSOURI
13000000640716OTHERMISSOURIBCBS
14146640006MEDICARE PINMISSOURI
15MA2027004MEDICARE PINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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