Individual provider Active NPI

Gregory Alexander Kogan, D.O.

  • Anesthesiology Physician
  • Pasadena, CA
National Provider Identifier
1831356708
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A 9419 Issued in CA
Practice address
2923 Bradley St
Pasadena, CA 91107-1502
Phone
(626) 795-6596
NPI assigned
May 19, 2008
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
Anesthesiology Physician 207L00000X 20A 9419 CA Primary

Addresses

Primary practice location

2923 Bradley St
Pasadena, CA 91107-1502

Mailing address

2923 Bradley St
Pasadena, CA 91107-1502
Phone (626) 795-6596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081114000332 CA Practitioner - Anesthesiology 0648330027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Western University of Health Sciences College of Dental Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buena Vista Anesthesia Medical GroupGroup PAC ID 7113975996, 51 clinicians

Practice addresses (Care Compare)

501 S Buena Vista St
Burbank, CA 91505-4866
Phone (818) 843-5111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 9419CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Hills Anesthesia and Perioperative Physicians Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
Buena Vista Anesthesia Medical Group Anesthesiology CurrentSince Jul 30, 2009 Accepting new patients
Buena Vista Surgery Center, LLC Past Accepting new patients

Locations

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

824 N Glendale Ave
Glendale, CA 91206
Phone (818) 247-0523

11550 Indian Hls
Mission Hills, CA 91345
Phone (818) 365-6632

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

27420 Tourney Rd
Ste 160
Valencia, CA 91355
Phone (661) 222-3100

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

Interoperability endpoints

  • Direct secure messaging: gkogan350402@oc.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831356708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 BRADLEY ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911071502",
            "telephone_number": "626-795-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 BRADLEY ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911071502",
            "telephone_number": "626-795-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "GREGORY",
        "middle_name": "ALEXANDER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A 9419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.