Individual provider Active NPI

Roger N Kahn, MD

  • Cardiovascular Disease Physician
  • Saginaw, MI
National Provider Identifier
1790824142
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4501035104 Issued in MI
Practice address
1015 S Washington Ave
Saginaw, MI 48601-2556
Phone
(989) 754-3000
Fax
(989) 755-1365
NPI assigned
Feb 5, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4501035104 MI Primary

Addresses

Primary practice location

1015 S Washington Ave
Saginaw, MI 48601-2556

Mailing address

1015 S Washington Ave
Saginaw, MI 48601-2556
Phone (989) 754-3000

Other practice location 1

295 Maple St Ste 202
Tawas City, MI 48763-9352
Phone (989) 362-6108

Other identifiers 1

IdentifierTypeStateIssuer
456595MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4501035104MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Cardiovascular Institute, PC Cardiovascular Disease Past Accepting new patients
Mymichigan Medical Center Tawas Past Accepting new patients
Great Lakes Bay Health Centers PastSince Jul 30, 2004 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790824142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S WASHINGTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012556",
            "telephone_number": "989-754-3000",
            "fax_number": "989-755-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S WASHINGTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012556",
            "telephone_number": "989-754-3000",
            "fax_number": "989-755-1365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Maple St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Tawas City",
            "state": "MI",
            "postal_code": "487639352",
            "country_code": "US",
            "telephone_number": "989-362-6108",
            "fax_number": "989-362-0161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAHN",
        "first_name": "ROGER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4501035104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "456595",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.