Angela Marie Kogut, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3535 S Smith Rd Ste a
Fairlawn, OH 44333-9270

Phone

(330) 208-2720

Fax

(330) 208-2721

NPI assigned

Nov 20, 2006

Sex

Female

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

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

At Still University, Arizona School of Dentistry & Oral HLTH, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Merit-based Incentive Payment System (MIPS)

Final score

84.85 of 100Reported as group

Quality

84.49

Promoting interoperability

83

Improvement activities

40

Cost

79.17

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kogut.angela@direct.azkrmc.md

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.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Medicare reassignment Care Compare group NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Physician Assistant

  NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1770657702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SANTA ROSA DR",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864012311",
            "telephone_number": "928-757-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S SMITH RD STE A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339270",
            "telephone_number": "330-208-2720",
            "fax_number": "330-208-2721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3780 Medina Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442569312",
            "country_code": "US",
            "telephone_number": "330-208-2720",
            "fax_number": "330-208-2721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3051 Graham Rd",
            "address_purpose": "LOCATION",
            "city": "Stow",
            "state": "OH",
            "postal_code": "442243654",
            "country_code": "US",
            "telephone_number": "330-208-2720",
            "fax_number": "330-208-2721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Wadsworth Rd",
            "address_2": "Rundle Building",
            "address_purpose": "LOCATION",
            "city": "Wadsworth",
            "state": "OH",
            "postal_code": "442819585",
            "country_code": "US",
            "telephone_number": "330-208-2720",
            "fax_number": "330-208-2721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1560 Corporate Woods Pkwy",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "OH",
            "postal_code": "446858730",
            "country_code": "US",
            "telephone_number": "330-208-2720",
            "fax_number": "330-208-2721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9150 Market Square Dr",
            "address_purpose": "LOCATION",
            "city": "Streetsboro",
            "state": "OH",
            "postal_code": "442414571",
            "country_code": "US",
            "telephone_number": "330-208-2720",
            "fax_number": "330-208-2721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOGUT",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2259532",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Klintworth, CNP
• Kristen Ann Knepp, PH.D.
• Kalen Matthias Knight
• Taylor Knotts
• Ann A Kobilarcik
• Kimberly Ann Kohl, MAOL, OTR/L
• Kaitlyn Marie Kolano, M.A., CF-SLP
• Crissy Ann Kolarik
• Douglas B Kolarik, M.D.
• Ayah Koleilat, DDS

• Physician Assistant in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.