Individual provider Active NPI

Benjamin D. Kogelschatz, MD

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
National Provider Identifier
1508516410
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301514465 Issued in MI
Practice address
2900 Bradford St NE
Grand Rapids, MI 49525-6427
Phone
(616) 885-5000
NPI assigned
Mar 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301514465 MI Primary

Addresses

Primary practice location

2900 Bradford St NE
Grand Rapids, MI 49525-6427

Mailing address

2900 Bradford St NE
Grand Rapids, MI 49525-6427
Phone (616) 885-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20230824002797 UT Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9234592114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301514465MIMDCardiovascular Disease Physician

Interoperability endpoints

  • Direct secure messaging: benjamin.kogelschatz.1@13794.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1508516410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRADFORD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256427",
            "telephone_number": "616-885-5000",
            "fax_number": "616-885-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRADFORD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256427",
            "telephone_number": "616-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGELSCHATZ",
        "first_name": "BENJAMIN",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301514465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.