Active NPI
Elena Kogan
- Diagnostic Ultrasound Physician
- Reseda, CA
National Provider Identifier
1033391065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Ultrasound Physician
- License
- TG132
- Practice address
- 18905 Sherman Way
2 ND Floor
Reseda, CA 91335-2600 - Phone
- (818) 705-0548
- Fax
- (818) 705-0579
- NPI assigned
- Nov 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Ultrasound Physician | 2085U0001X | TG132 | CA | Primary |
Addresses
Primary practice location
18905 Sherman Way
2 ND Floor
Reseda, CA 91335-2600
Mailing address
18905 Sherman Way
2 ND Floor
Reseda, CA 91335-2600
Phone (818) 705-0548
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TG132 | CA | MD | Diagnostic Ultrasound Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Diagnostic Imaging Services Inc | Diagnostic Ultrasound | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Diagnostic Ultrasound Physician
- Reseda, CA
- NPI 1487661427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196380800000",
"number": "1033391065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18905 SHERMAN WAY",
"address_2": "2 ND FLOOR",
"city": "RESEDA",
"state": "CA",
"postal_code": "913352600",
"telephone_number": "818-705-0548",
"fax_number": "818-705-0579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18905 SHERMAN WAY",
"address_2": "2 ND FLOOR",
"city": "RESEDA",
"state": "CA",
"postal_code": "913352600",
"telephone_number": "818-705-0548",
"fax_number": "818-705-0579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOGAN",
"first_name": "ELENA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-30",
"last_updated": "2007-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "CA",
"license": "TG132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reseda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.