NPIMap

Individual provider Active NPI

Connor Flynn Rogan, MD

  • Family Medicine Physician
  • Kodiak, AK
National Provider Identifier
1861079246
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
238556 Issued in AK
Practice address
3449 E Rezanof Dr
Kodiak, AK 99615-6952
Phone
(907) 486-9870
NPI assigned
Mar 24, 2021
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 238556 AK Primary

Addresses

Primary practice location

3449 E Rezanof Dr
Kodiak, AK 99615-6952

Mailing address

3449 E Rezanof Dr
Kodiak, AK 99615-6952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250929003946 TX Practitioner - Internal Medicine 3173922218 Reassigns benefits to 1 organization
I20251106001771 AK Practitioner - Family Practice 3173922218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kodiak Area Native AssociationGroup PAC ID 8426959297, 36 clinicians

Practice addresses (Care Compare)

3449 E Rezanof Dr
Alutiiq Enwia
Kodiak, AK 99615-6952
Phone (907) 486-9800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238556AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Jan 1, 2026 Accepting new patients
Kodiak Area Native Association CurrentSince Sep 2, 2025 Accepting new patients
Providence Health & Services - Washington CurrentSince Oct 1, 2025 Accepting new patients
Providence Health & Services Washington CurrentSince Oct 1, 2025 Accepting new patients
Kodiak Area Native Association Past Accepting new patients

Locations

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

3449 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-9800

Interoperability endpoints

  • Direct secure messaging: crogan1450597@ak.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1861079246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156952",
            "telephone_number": "907-486-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGAN",
        "first_name": "CONNOR",
        "middle_name": "FLYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "238556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kodiak, AK

Sources for this page

Verify at the official NPI Registry.