Organization Active NPI

Val Koganski MD PC

Doing business as NIM Longevity

  • Internal Medicine Physician
  • Langhorne, PA
National Provider Identifier
1093864043
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
VAL KOGANSKI MD PC
Doing business as
NIM Longevity
Newtown Internal Medicine
Practice address
1717 Langhorne Newtown Rd Ste 402
Langhorne, PA 19047-1086
Phone
(215) 750-7000
Fax
(215) 750-9572
NPI assigned
Jan 9, 2007
Last updated
Dec 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Valeri KoganskiNPI 1285696948
Title
Owner
Phone
(215) 750-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1717 Langhorne Newtown Rd Ste 402
Langhorne, PA 19047-1086

Mailing address

1717 Langhorne Newtown Rd Ste 402
Langhorne, PA 19047-1086
Phone (215) 750-7000

Other identifiers 6

IdentifierTypeStateIssuer
6121985OtherPACIGNA
H706318OtherPAAETNA
0016014800004MedicaidPA
1090692OtherPAKEYSTONE MERCY
2119889000OtherPAINDEPENDENCE BLUE CROSS
1432525OtherPABLUE SHIELD

Other names 2

  • NIM Longevity Doing business as
  • Newtown Internal Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Val.Koganski@vcog.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421001191 PA Part B Supplier - Clinic/Group Practice 4880632686 Receives reassigned benefits from 2 practitioners
Practice locations: Langhorne, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0948424Newtown Internal Medicine1717 Langhorne Newtown Road, Langhorne, PA 19047Certificate of waiverSep 4, 2026

National Provider Directory

National Provider Directory

Locations

1205 Langhorne Newtown Rd
Ste 411
Langhorne, PA 19047
Phone (215) 750-7000

1717 Langhorne Newtown Rd
Ste 402
Langhorne, PA 19047
Phone (215) 750-7000

Interoperability endpoints

  • Direct secure messaging: val.koganski@vcog.eclinicaldirectplus.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1093864043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 LANGHORNE NEWTOWN RD STE 402",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471086",
            "telephone_number": "215-750-7000",
            "fax_number": "215-750-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 LANGHORNE NEWTOWN RD STE 402",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471086",
            "telephone_number": "215-750-7000",
            "fax_number": "215-750-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAL KOGANSKI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "KOGANSKI",
        "authorized_official_first_name": "VALERI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-750-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6121985",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "H706318",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016014800004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1090692",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2119889000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1432525",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Val.Koganski@vcog.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Val Koganski Office Direct Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1717 Langhorne Newtown Rd Ste 402",
            "city": "Langhorne",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190471086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NIM Longevity",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newtown Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.