Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Su Min Ko, MD

Individual provider Interventional Pain Medicine Physician · NPI 1336375450

Dr. Su Min Ko, MD is a Physical Medicine and Rehabilitation in Fairfax, Virginia. Qualified in 1996, 30 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Missouri and Virginia.

Years since qualifying
30
Licensed in
MO, VA
In the registry since
2009
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

11166 Fairfax Blvd Ste 105
Fairfax, VA 22030-5017
Phone: (703) 277-3360
Fax: (703) 277-3370
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X · Licence 0101250991 (VA)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 2009001606 (MO)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X · Licence 2009001606 (MO)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X · Licence 0101250991 (VA)

Record details

NPI number1336375450
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 3, 2009
Last updated in NPPESFebruary 20, 2017
Mailing address11166 Fairfax Blvd, Suite 105, Fairfax, VA 22030-5017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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