Frederick Joseph Kogan, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

12265 Issued in AZ

Practice address

6707 N 19TH Ave
Suite 200
Phoenix, AZ 85015-1104

Phone

(602) 249-4750

Fax

(602) 249-4814

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Banner Arizona Medical Clinic LTD

  • Multi-Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1750347936
  NPD
• Reddy Gi Associates

  • Gastroenterology Physician
  • Mesa, AZ
  • NPI 1194957241
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1831146117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14410 N. 14TH ST.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224446",
            "telephone_number": "602-375-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 N 19TH AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151104",
            "telephone_number": "602-249-4750",
            "fax_number": "602-249-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "FREDERICK",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "12265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefan Wolfgang Koester
• Charlotte Miriam Koestner, LCSW
• May Elizabeth Koestner, PT, DPT
• Reagan Elizabeth Koetting
• Iniobong Koffi, PMHNP-BC
• Paul Kogan, DDS
• Jaime Koger
• Barbara C Kogut, RDH
• Jessica Koh, M.A.
• Mario Kohan

• Gastroenterology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.