DR. WILLIS KO (MD) – Internal Medicine Physician, NPI 1215465307
Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
464 INTERVENTIONAL CARDIOLOGY in IL
Provider Addresses for DR. WILLIS KO (MD)
6810 STATE ROUTE 162 STE 102B
MARYVILLE, IL 620628560
Phone: (618) 288-4076
Fax: (618) 288-4215
Type: Location
230 N Broad Street
Hahnemann University Hospital
Philadelphia, PA 19102
Phone: (215) 762-7000
Type: Location
5645 Main St
Flushing, NY 113555045
Phone: (718) 670-2000
Type: Location
201 14th St SW
Largo, FL 337703133
Phone: (727) 588-3700
Fax: (727) 585-7205
Type: Location
East Main Street, Flushing, Genesee County, Michigan, 48433, United States
FLUSHING, NY 113555045
Phone:
Type: Mailing
660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 631418512
Phone: (314) 448-3791
Fax: (314) 996-7658
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 49 Open Payments records for all available years, with a total value of $2,338.
Total Amount is formed as General ($2,338) + Research ($0) + Ownership ($0) = $2,338.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Abbott Laboratories ($536).
Total Amount
$2,338
General + Research + Ownership
Payments
49
Total payment records
General Amount
$2,338
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $536 |
| Medtronic, Inc. | $510 |
| Shockwave Medical, Inc | $229 |
| Inari Medical, Inc. | $213 |
| Amgen Inc. | $143 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240822000341 | I | Interventional Cardiology | MO | TBD |
| I20240827001851 | I | Interventional Cardiology | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62062)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| G A S T R O E N T E R O L O G Y | GA | |
| Physician Assistant | IL | |
| - | MO | |
| Gastroenterology, Gastroenterology, Internal Medicine | OH |
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