Individual provider Active NPI

Teresa Maria Mogielnicki, M.D.

  • Family Medicine Physician
  • El Cajon, CA
National Provider Identifier
1043202765
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A44498 Issued in CA
Practice address
5442 Sycuan Rd
El Cajon, CA 92019-1816
Phone
(619) 445-0707
Fax
(619) 445-0988
NPI assigned
Aug 18, 2005
Last updated
May 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A44498 CA Primary

Addresses

Primary practice location

5442 Sycuan Rd
El Cajon, CA 92019-1816

Mailing address

5442 Sycuan Rd
El Cajon, CA 92019-1816
Phone (619) 445-0707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000140 CA Practitioner - Family Practice 4981892874

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44498CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sycuan Tribal Government Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1043202765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5442 SYCUAN RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920191816",
            "telephone_number": "619-445-0707",
            "fax_number": "619-445-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5442 SYCUAN RD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920191816",
            "telephone_number": "619-445-0707",
            "fax_number": "619-445-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGIELNICKI",
        "first_name": "TERESA",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.