Individual provider Active NPI

Catherine Cogley, MD

  • Pediatrics Physician
  • Port Orchard, WA
National Provider Identifier
1366476509
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00045135 Issued in WA
Practice address
450 S Kitsap Blvd Ste 230
Port Orchard, WA 98366-3738
Phone
(360) 895-0216
Fax
(360) 895-7919
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00045135 WA Primary

Addresses

Primary practice location

450 S Kitsap Blvd Ste 230
Port Orchard, WA 98366-3738

Mailing address

450 S Kitsap Blvd Ste 230
Port Orchard, WA 98366-3738
Phone (360) 895-0216

Other identifiers 2

IdentifierTypeStateIssuer
8446965MedicaidWA
MD00045135OtherWAMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20051012000528 WA Practitioner - Pediatric Medicine 2769407394 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Sep 1, 2023 Accepting new patients
Multicare Health System CurrentSince Sep 1, 2023 Accepting new patients
Multicare Health System Past Accepting new patients
Kitsap Childrens Clinic LLP Pediatrics Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

316 S K St
Ste 212
Tacoma, WA 98405
Phone (253) 383-5777

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366476509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD STE 230",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663738",
            "telephone_number": "360-895-0216",
            "fax_number": "360-895-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD STE 230",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663738",
            "telephone_number": "360-895-0216",
            "fax_number": "360-895-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGLEY",
        "first_name": "CATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00045135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8446965",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "MD00045135",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

Verify at the official NPI Registry.