Active NPI
Matthew William Kohan, M.D.
- Surgery Physician
- Greenville, NC
National Provider Identifier
1861713729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- C196917
- Practice address
- 517 Moye Blvd
Greenville, NC 27834-2849 - Phone
- (252) 847-4299
- Fax
- (252) 847-8208
- NPI assigned
- Jun 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2014-02474 | NC | |
| Surgery Physician | 208600000X | C196917 | CA | Primary |
Addresses
Primary practice location
517 Moye Blvd
Greenville, NC 27834-2849
Mailing address
PO Box 555191
Camp Pendleton, CA 92055-5191
Phone (814) 577-9031
Other practice location 1
101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8888
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014-02474 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Surgeons of Orange a Medical Group | Surgery | Current | Accepting new patients |
| East Carolina University | Past | Accepting new patients |
Locations
101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054
200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001
Organizations & group practices 2
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.
-
- Surgery Physician
- Orange, CA
- NPI 1407806904
-
- Obstetrics & Gynecology Physician
- Greenville, NC
- NPI 1528016938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1861713729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 555191",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "920555191",
"telephone_number": "814-577-9031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 MOYE BLVD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342849",
"telephone_number": "252-847-4299",
"fax_number": "252-847-8208"
}
],
"practiceLocations": [
{
"address_1": "101 The City Dr S",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "928683201",
"country_code": "US",
"telephone_number": "714-456-8888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOHAN",
"first_name": "MATTHEW",
"middle_name": "WILLIAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-15",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "2014-02474",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "C196917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.