Samuel Kogan, MD/PHD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

2026-01745 Issued in NC

Practice address

170 Medical Park Rd Ste 210
Mooresville, NC 28117-8583

Phone

(704) 663-0006

NPI assigned

Mar 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1679100697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MEDICAL PARK RD STE 210",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178583",
            "telephone_number": "704-663-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MEDICAL PARK RD STE 210",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178583",
            "telephone_number": "704-663-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "SAMUEL",
        "credential": "MD/PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "2026-01745",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "2026-01745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert G Kloo Jr., RPH
• Alannah Nichole Knight, MS, BCBA, LBA
• Rachel Knowles
• Sandra Natalie Koch, DPM
• Alison Koehler, M.D.
• Kayla Joanna Kolivras
• Heather Carroll Kompanik, M.D.
• John B. Konefal, M.D.
• David Benjamin Konstandt, M.D.
• Christina Kontos

• Plastic Surgery Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.

Verify at the official NPI Registry.