Active NPI
Kenneth A. Hogrefe, MD
- Ophthalmology Physician
- Corning, NY
National Provider Identifier
1669440137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 144719-1
- Practice address
- 130 Centerway
Corning, NY 14830 - Phone
- (607) 936-9971
- Fax
- (607) 936-2600
- NPI assigned
- Mar 10, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD53407L | PA | |
| Ophthalmology Physician | 207W00000X | 144719-1 | NY | Primary |
Addresses
Primary practice location
130 Centerway
Corning, NY 14830
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CC8362 | Other | NY | RR MEDICARE GROUP |
| 0011461900003 | Medicaid | PA | |
| 00779846 | Medicaid | NY | |
| 180042769 | Other | NY | RR MEDICARE PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | khogrefe1444@direct-guthrie.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 144719-1 | NY | MD | Ophthalmology Physician |
| MD53407L | PA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group, P.C. | Current | Accepting new patients |
Locations
130 Center Way
Corning, NY 14830
Phone (607) 936-9971
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Interoperability endpoints
- khogrefe14444@direct-guthrie.org
- khogrefe1444@direct-guthrie.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.
-
- Multi-Specialty Clinic/Center
- Corning, NY
- NPI 1134178635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1669440137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 CENTERWAY",
"city": "CORNING",
"state": "NY",
"postal_code": "14830",
"telephone_number": "607-936-9971",
"fax_number": "607-936-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGREFE",
"first_name": "KENNETH",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2021-03-04",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "PA",
"license": "MD53407L",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "144719-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC8362",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0011461900003",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00779846",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "180042769",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khogrefe1444@direct-guthrie.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "130 Centerway",
"city": "Corning",
"state": "NY",
"country_code": "US",
"postal_code": "14830",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Corning, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.