Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jesse Kogelman, PA-C

Individual provider Medical Physician Assistant · NPI 1144503491

Jesse Kogelman, PA-C is a Physician Assistant in Traverse City, Michigan. Qualified in 2011, 15 years ago. Practices with Northwestern Michigan Dermatology PC, a 4-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
15
Licensed in
MI
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

550 Munson Ave Ste 200
Traverse City, MI 49686-3580
Phone: (231) 935-8717
Fax: (231) 935-9230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601006005 (MI)

Record details

NPI number1144503491
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 22, 2011
Last updated in NPPESOctober 2, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Northwestern Michigan Dermatology P.C. — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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