Individual provider Active NPI

Justin Hogan, PA-C

  • Physician Assistant
  • Asheville, NC
National Provider Identifier
1902220213
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04859 Issued in NC
Practice address
16 Medical Park Dr
Asheville, NC 28803-2493
Phone
(828) 274-4880
NPI assigned
Feb 6, 2014
Last updated
Feb 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA203040 OR
Physician Assistant 363A00000X NC
Physician Assistant 363A00000X 0010-04859 NC Primary

Addresses

Primary practice location

16 Medical Park Dr
Asheville, NC 28803-2493

Mailing address

16 Medical Park Dr
Asheville, NC 28803-2493
Phone (828) 274-4880

Other practice location 1

11 River Ridge Dr
Asheville, NC 28803-1299
Phone (828) 298-6350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140512000792 NC Practitioner - Physician Assistant 2961635289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology and Skin Surgery PAGroup PAC ID 9830115997, 14 clinicians

Practice addresses (Care Compare)

12 Medical Park Dr
Asheville, NC 28803-2493
Phone (828) 274-4880

16 Medical Park Dr
Asheville, NC 28803-2493
Phone (828) 274-4880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Laurel Dermatology, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: justinhogan@advancedskindoctor.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1902220213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MEDICAL PARK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032493",
            "telephone_number": "828-274-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MEDICAL PARK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032493",
            "telephone_number": "828-274-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 River Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288031299",
            "country_code": "US",
            "telephone_number": "828-298-6350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA203040",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.