NPIMap

Individual provider Active NPI

Kenneth Karl Wogensen, MD

  • Neurology Physician
  • Arcadia, CA
National Provider Identifier
1932109295
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G52870 Issued in CA
Practice address
1015 N First Avenue
Suite a
Arcadia, CA 91006-2534
Phone
(626) 566-2866
Fax
(626) 566-2850
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G52870 CA Primary

Addresses

Primary practice location

1015 N First Avenue
Suite a
Arcadia, CA 91006-2534

Mailing address

1015 N First Avenue
Suite a
Arcadia, CA 91006-2534
Phone (626) 566-2866

Other practice location 1

255 E Bonita Ave Bldg 9
Pomona, CA 91767-1923
Phone (626) 566-2866 ext. 115

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ARCADIA Health Information Exchange (HIE) Kenneth K. Wogensen, MD. Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000505 CA Practitioner - Neurology 8921032061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of California, Irvine, California College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1015 N 1St Ave
Apt a
Arcadia, CA 91006-7401
Phone (626) 566-2866

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G52870CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth K. Wogensen, MD. Inc Neurology CurrentSince Sep 1, 2005 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Scott C Lederhaus MD & Lew B Disney MD PRT Lederhaus Scott C Gen PTR Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Huntington Hospital Association Past Accepting new patients

Locations

665 W Naomi Ave
Ste 201
Arcadia, CA 91007
Phone (626) 445-8481

255 E Bonita Ave
Bldg 9
Pomona, CA 91767
Phone (909) 450-0369

255 E Bonita Ave
Ste 9
Pomona, CA 91767

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: clinic.casacolina@direct.casacolina.org
  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 6

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 4

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1932109295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N FIRST AVENUE",
            "address_2": "SUITE A",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910062534",
            "telephone_number": "626-566-2866",
            "fax_number": "626-566-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N FIRST AVENUE",
            "address_2": "SUITE A",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910062534",
            "telephone_number": "626-566-2866",
            "fax_number": "626-566-2850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 E Bonita Ave Bldg 9",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671923",
            "country_code": "US",
            "telephone_number": "626-566-2866 x115",
            "fax_number": "626-566-2850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOGENSEN",
        "first_name": "KENNETH",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2023-03-07",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G52870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ARCADIA",
            "affiliation": "Y",
            "affiliationName": "Kenneth K. Wogensen, MD. Inc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ARCADIA",
            "address_1": "1015 N First Avenue",
            "address_2": "Suite A",
            "city": "Arcadia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910062534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.