Individual provider Active NPI

Lawrence Joseph Gogenola, MD

  • Dermatology Physician
  • Bellevue, WA
National Provider Identifier
1407953003
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00024909 Issued in WA
Practice address
1551 116TH Ave NE
Bellevue, WA 98004
Phone
(425) 455-2275
Fax
(425) 455-1511
NPI assigned
Sep 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00024909 WA Primary

Addresses

Primary practice location

1551 116TH Ave NE
Bellevue, WA 98004

Mailing address

1551 116TH Ave NE
Bellevue, WA 98004
Phone (425) 455-2275

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
I20090812000393 WA Practitioner - Dermatology 0840344784 Practice locations: Bellevue, WA

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Washington School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1810 116TH Ave NE
Bellevue, WA 98004-3058

1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3043
Phone (425) 455-2275

1810 116TH NE Ave
Suite 100
Bellevue, WA 98004-3043

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions412
Removal or shaving of skin growth1-10
Skin biopsy117

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1407953003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-455-2275",
            "fax_number": "425-455-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-455-2275",
            "fax_number": "425-455-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGENOLA",
        "first_name": "LAWRENCE",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00024909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.