Dr Su Min Ko, MD - Medicare Interventional Pain Management in Fairfax, VA

Dr Su Min Ko, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Fairfax, Virginia. He graduated from medical school in 1996 and has 28 years of diverse experience with area of expertise as Interventional Pain Management. His current practice location is 11166 Fairfax Blvd, Suite 105, Fairfax, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 277-3360.

Dr Su Min Ko is licensed to practice in Virginia (license number 0101250991) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1336375450.

Contact Information

Dr Su Min Ko, MD
11166 Fairfax Blvd, Suite 105,
Fairfax, VA 22030-5017
(703) 277-3360
(703) 277-3370



Physician's Profile

Full NameDr Su Min Ko
GenderMale
SpecialityInterventional Pain Management
Experience28 Years
Location11166 Fairfax Blvd, Fairfax, Virginia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Su Min Ko graduated from medical school in 1996
  NPI Data:
  • NPI Number: 1336375450
  • Provider Enumeration Date: 06/03/2009
  • Last Update Date: 02/20/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 3678627916
  • Enrollment ID: I20121203000017

Medical Identifiers

Medical identifiers for Dr Su Min Ko such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336375450NPI-NPPES
9496409OtherMOAETNA
98246OtherMOHCUSA
2009001606OtherMOMEDICAL LICENSE
000000640716OtherMOBCBS
1336375450MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208VP0014XPain Medicine - Interventional Pain Medicine 0101250991 (Virginia)Primary
208100000XPhysical Medicine & Rehabilitation 2009001606 (Missouri)Secondary
2081P2900XPhysical Medicine & Rehabilitation - Pain Medicine 2009001606 (Missouri)Secondary
2081P2900XPhysical Medicine & Rehabilitation - Pain Medicine 0101250991 (Virginia)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Su Min Ko allows following entities to bill medicare on his behalf.
Entity NameBetter Life Pain Clinic, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659792323
PECOS PAC ID: 8426200296
Enrollment ID: O20121203000013

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Entity NameVirginia Integrative Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568809713
PECOS PAC ID: 9830324391
Enrollment ID: O20131108001653

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Su Min Ko is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Su Min Ko, MD
11166 Fairfax Blvd, Suite 105,
Fairfax, VA 22030-5017

Ph: (703) 277-3360
Dr Su Min Ko, MD
11166 Fairfax Blvd, Suite 105,
Fairfax, VA 22030-5017

Ph: (703) 277-3360

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Pain Medicine Doctors in Fairfax, VA

Dr. Loren L. Friedman, MD
Pain Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 8503 Arlington Blvd Ste 400, Fairfax, VA 22031
Phone: 703-280-5390    Fax: 703-280-9596

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