Alan Otto Kogan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301028081 Issued in MI

Practice address

610 E Diamond Ave
Suite 100a
Gaithersburg, MD 20877-5321

Phone

(301) 840-3200

Fax

(301) 840-1348

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1659437671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE",
            "address_2": "SUITE 100A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-840-3200",
            "fax_number": "301-840-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE",
            "address_2": "SUITE 100A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-840-3200",
            "fax_number": "301-840-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "ALAN",
        "middle_name": "OTTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301028081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "816700100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emily Kolyabina, LCSW-C
• Jennifer Koo

• Psychiatry Physician in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.