Organization Active NPI

Neurology Clinic of Marin, a Medical Corporation

  • Neurology Physician
  • San Anselmo, CA
National Provider Identifier
1518999010
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A71057 Issued in CA
Legal business name
NEUROLOGY CLINIC OF MARIN, A MEDICAL CORPORATION
Practice address
50 Red Hill Ave
San Anselmo, CA 94960
Phone
(415) 456-8180
Fax
(415) 453-4898
NPI assigned
Jul 7, 2006
Last updated
Feb 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Authorized official

Name
Dr. Ilkcan Cokgor, M.D.NPI 1235100603
Title
Pres
Phone
(415) 456-8180

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
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X A71057 CA Primary

Addresses

Primary practice location

50 Red Hill Ave
San Anselmo, CA 94960

Mailing address

PO Box 618
Novato, CA 94948-0618
Phone (415) 456-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050714000587 CA Part B Supplier - Clinic/Group Practice 1557397114 Receives reassigned benefits from 1 practitioner
Practice locations: San Anselmo, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: ilkcancokgor@ncm.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 1

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1518999010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 618",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949480618",
            "telephone_number": "415-456-8180",
            "fax_number": "415-453-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 RED HILL AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "94960",
            "telephone_number": "415-456-8180",
            "fax_number": "415-453-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CLINIC OF MARIN, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "COKGOR",
        "authorized_official_first_name": "ILKCAN",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "415-456-8180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A71057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.