Shelli Kogan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

250847 Issued in NY

Practice address

25 Kilmer Dr
Ste 105
Morganville, NJ 07751-1561

Phone

(732) 851-7111

Fax

(732) 851-7008

NPI assigned

Oct 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Manhattan Beach Int Med PC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1790870962
  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1992958599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KILMER DR",
            "address_2": "STE 105",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511561",
            "telephone_number": "732-851-7111",
            "fax_number": "732-851-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 KILMER DR",
            "address_2": "STE 105",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511561",
            "telephone_number": "732-851-7111",
            "fax_number": "732-851-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "SHELLI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "250847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Kelter, M.D.
• Kathy Rosen Kerr, MD
• Shaviahnah King
• Jessie Klar, PA-C
• Charles Ko
• Carrie M Koo, L.AC
• Eli Korn, R.PH.
• Yana Kozlovsky, DMD
• Megan M Kret, OTR/L
• Kroll Medical Group Inc

• Family Medicine Physician in Morganville, NJ
• Providers in Morganville, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.