Individual ProviderSimon RyooRadiologyAllopathic & Osteopathic PhysiciansPractice Address227 Franklin Ave, Hewlett, NY 11557-1902(516) 295-5500(516) 354-4200PECOS EnrollmentBased on the most recent information from CMS, provider Simon Ryoo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 12:57 PM.Profile DetailsProvider ID1962668442Provider TypeIndividualFull NameRyoo, SimonTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date8/4/2008Last Updated12/20/2011Contact InformationPractice LocationPractice Address227 Franklin Ave, Hewlett, NY 11557-1902Phone(516) 295-5500Fax(516) 569-8225Mailing LocationMailing Address545 Elmont Rd, Elmont, NY 11003-4002Phone(516) 354-4200Fax(516) 775-1972Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense250426New YorkProvider IdentifiersIDDescriptionIssuerID03256508DescriptionMedicaidIssuerUnlistedNew York