Active NPI
Kelly Ann Kogut, M.D., P.C.
- Pediatric Surgery Physician
- Las Vegas, NV
National Provider Identifier
1881694719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 9338
- Practice address
- 653 N Town Center Dr
Suite 507
Las Vegas, NV 89144-0514 - Phone
- (702) 233-8101
- Fax
- (702) 242-0726
- NPI assigned
- Jul 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | 9338 | NV | Primary |
Addresses
Primary practice location
653 N Town Center Dr
Suite 507
Las Vegas, NV 89144-0514
Mailing address
653 N Town Center Dr
Suite 507
Las Vegas, NV 89144-0514
Phone (702) 233-8101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002018507 | Medicaid | NV |
Other names 1
- Kelly Ann Kogut
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9338 | NV | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summerlin Hospital Medical Center L L C | Past | Accepting new patients | |
| Pediatric Surgery Associates | Pediatric Surgery | Past | Accepting new patients |
Interoperability endpoints
- pediatricsurgeryassociatesltd.kellykogut@113846.advancedmd-direct.com
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.
-
- Pediatric Surgery Physician
- Las Vegas, NV
- NPI 1588784623
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1831189638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1881694719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "653 N TOWN CENTER DR",
"address_2": "SUITE 507",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891440514",
"telephone_number": "702-233-8101",
"fax_number": "702-242-0726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 N TOWN CENTER DR",
"address_2": "SUITE 507",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891440514",
"telephone_number": "702-233-8101",
"fax_number": "702-242-0726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOGUT",
"first_name": "KELLY",
"middle_name": "ANN",
"credential": "M.D., P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-21",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "NV",
"license": "9338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002018507",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "KOGUT",
"middle_name": "ANN",
"credential": "M.D., P.C.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.