Individual provider Active NPI

Philip G Kogos, MD

  • Diagnostic Radiology Physician
  • Marrero, LA
National Provider Identifier
1205865037
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
TL28763 Issued in SC
Practice address
1101 Medical Center Blvd
Radiology Dept
Marrero, LA 70072-3147
Phone
(504) 349-1461
Fax
(504) 349-1470
NPI assigned
Jul 2, 2006
Last updated
Oct 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X TL28763 SC Primary

Addresses

Primary practice location

1101 Medical Center Blvd
Radiology Dept
Marrero, LA 70072-3147

Mailing address

1111 Medical Center Blvd
Suite N-108
Marrero, LA 70072-3151
Phone (504) 349-1461

Other identifiers 3

IdentifierTypeStateIssuer
287638MedicaidSC
03930313MedicaidMS
1197378MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000879 LA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 7416960968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Radiology Associates, Inc.Group PAC ID 0143289363, 14 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3191
Phone (504) 349-1461

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TL28763SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Radiology Associates, Inc Diagnostic Radiology CurrentSince Aug 1, 2008 Accepting new patients
West Jefferson MRI, LLC CurrentSince Aug 1, 2008 Accepting new patients
Westcare Medical Center, Inc CurrentSince Apr 12, 2017 Accepting new patients
West Jefferson MRI, LLC CurrentSince Aug 1, 2008 Accepting new patients

Locations

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

1111 Medical Center Blvd
Ste N108
Marrero, LA 70072
Phone (504) 349-1461

1111 Medical Center Blvd
Ste N110
Marrero, LA 70072
Phone (504) 349-6191

1220 Barataria Blvd
Marrero, LA 70072
Phone (504) 340-6711

4525 Westbank Expy
Ste B
Marrero, LA 70072
Phone (504) 349-6570

2121 Ridgelake Dr
Metairie, LA 70001
Phone (504) 258-3992

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

5620 Read Blvd
New Orleans, LA 70127
Phone (504) 241-2664

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GABFAD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1205865037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N-108",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "address_2": "RADIOLOGY DEPT",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723147",
            "telephone_number": "504-349-1461",
            "fax_number": "504-349-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGOS",
        "first_name": "PHILIP",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "TL28763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287638",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03930313",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1197378",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.