Individual provider Active NPI

Michael Koegel, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1992741086
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
165060-1 Issued in NY
Practice address
1911 Avenue L
Brooklyn, NY 11230-5002
Phone
(718) 859-3499
Fax
(718) 377-2250
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 165060-1 NY Primary

Addresses

Primary practice location

1911 Avenue L
Brooklyn, NY 11230-5002

Mailing address

1911 Avenue L
Brooklyn, NY 11230-5002
Phone (718) 859-3499

Other identifiers 1

IdentifierTypeStateIssuer
01018208MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
165060-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Michael M. Koegel M.D. & Associates Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michaelkoegel@mai.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1992741086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305002",
            "telephone_number": "718-859-3499",
            "fax_number": "718-377-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305002",
            "telephone_number": "718-859-3499",
            "fax_number": "718-377-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEGEL",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "165060-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01018208",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.