Organization Active NPI

Koga LLC

  • Neurological Surgery Physician
  • Covington, LA
National Provider Identifier
1346880010
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
KOGA LLC
Practice address
187 Greenbrier Blvd Ste a
Covington, LA 70433-7299
Phone
(985) 269-7676
NPI assigned
Jan 10, 2020
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Sebastian KogaNPI 1710191184
Title
Authorized Official
Phone
(504) 680-8383

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
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

187 Greenbrier Blvd Ste a
Covington, LA 70433-7299

Mailing address

187 Greenbrier Blvd Ste a
Covington, LA 70433-7299

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL will@ihealthmanagement.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200312001645 LA Part B Supplier - Clinic/Group Practice 2567890122 Receives reassigned benefits from 3 practitioners
Practice locations: Covington, LA
O20240326004157 MS Part B Supplier - Clinic/Group Practice 2567890122 Receives reassigned benefits from 1 practitioner
Practice locations: Pascagoula, MS

National Provider Directory

National Provider Directory

Locations

189 Greenbrier Blvd
Ste C
Covington, LA 70433
Phone (985) 269-7676

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20809/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1346880010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 GREENBRIER BLVD STE A",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 GREENBRIER BLVD STE A",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337299",
            "telephone_number": "985-269-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOGA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "KOGA",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "504-680-8383"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "will@ihealthmanagement.net",
            "affiliation": "N",
            "endpointDescription": "Work admin email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "187 Greenbrier Blvd Ste A",
            "city": "Covington",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704337299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.