Individual provider Active NPI

Mitchell A Kohan, DPM

  • Podiatrist
  • Nesconset, NY
National Provider Identifier
1104818830
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004249 Issued in NY
Practice address
276 Smithtown Blvd
Nesconset, NY 11767-2043
Phone
(631) 467-7600
Fax
(631) 467-0945
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004249 NY Primary

Addresses

Primary practice location

276 Smithtown Blvd
Nesconset, NY 11767-2043

Mailing address

276 Smithtown Blvd
Nesconset, NY 11767-2043
Phone (631) 467-7600

Other identifiers 1

IdentifierTypeStateIssuer
01081474MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000953 NY Practitioner - Podiatry 4880643790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvey a Freedman DPM PCGroup PAC ID 6305957192, 2 clinicians

Practice addresses (Care Compare)

276 Smithtown Blvd
Nesconset, NY 11767-2084
Phone (631) 724-8285

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as individual
Quality
50.82
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue184
Removal of skin lesions26
Removal of nail tissue321
Removal or shaving of skin growth265
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004249NYMDPodiatrist
004249NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey a Freedman DPM PC Podiatrist CurrentSince Jan 1, 1988 Accepting new patients

Locations

276 Smithtown Blvd
Ste 1
Nesconset, NY 11767
Phone (631) 724-8285

276 Smithtown Blvd
Nesconset, NY 11767
Phone (631) 467-7600

Interoperability endpoints

  • Direct secure messaging: mkohan@hafdp-ny.direct.office.nextgen.com
  • Direct secure messaging: mkohan12050@direct-chsli.net

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104818830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672043",
            "telephone_number": "631-467-7600",
            "fax_number": "631-467-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672043",
            "telephone_number": "631-467-7600",
            "fax_number": "631-467-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHAN",
        "first_name": "MITCHELL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01081474",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.