Active NPI
Manuela M. Kogon, MD
- Psychiatry Physician
- Stanford, CA
National Provider Identifier
1508993593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A76902
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A76902 | CA | Primary |
| Internal Medicine Physician | 207R00000X | A76902 | CA |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
Other practice location 1
211 Quarry Rd
Palo Alto, CA 94304-1416
Phone (650) 498-5566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090399 | Other | SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanford Health Care | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- mkogon41012@direct.stanfordhealthcare.org
Organizations & group practices 1
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": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1508993593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "211 Quarry Rd",
"address_purpose": "LOCATION",
"city": "Palo Alto",
"state": "CA",
"postal_code": "943041416",
"country_code": "US",
"telephone_number": "650-498-5566",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOGON",
"first_name": "MANUELA",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A76902",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A76902",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER",
"identifier": "090399",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.