Individual provider Active NPI

Harriette Rosen Mogul, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Valhalla, NY
National Provider Identifier
1043234693
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
104864 Issued in NY
Practice address
401 Columbus Ave Lowr Level
Valhalla, NY 10595-1326
Phone
(914) 347-0162
Fax
(914) 347-4401
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 104864 NY Primary

Addresses

Primary practice location

401 Columbus Ave Lowr Level
Valhalla, NY 10595-1326

Mailing address

401 Columbus Ave Lowr Level
Valhalla, NY 10595-1326
Phone (914) 473-0162

Other practice location 1

95 Grasslands Rd
Nymc - Dept of Medicine-Munger Pavilion
Valhalla, NY 10595
Phone (914) 594-4245

Other identifiers 3

IdentifierTypeStateIssuer
110063317OtherRAILROAD MEDICARE
WP341OtherNYOXFORD
01415443MedicaidNY

Other names 1

  • Dr. Harriette Rosrn Mogul Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080409000142 NY Practitioner - Internal Medicine 4880771211 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Intensivists, PC CurrentSince Jan 16, 2018 Accepting new patients

Locations

672 Stoneleigh Ave
Bldg 66
Carmel, NY 10512
Phone (914) 347-0162

19 Bradhurst Ave
#1700
Hawthorne, NY 10532
Phone (914) 347-0162

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1043234693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COLUMBUS AVE LOWR LEVEL",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951326",
            "telephone_number": "914-473-0162",
            "fax_number": "914-347-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 COLUMBUS AVE LOWR LEVEL",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951326",
            "telephone_number": "914-347-0162",
            "fax_number": "914-347-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 GRASSLANDS RD",
            "address_2": "NYMC - DEPT OF MEDICINE-MUNGER PAVILION",
            "address_purpose": "LOCATION",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "10595",
            "country_code": "US",
            "telephone_number": "914-594-4245",
            "fax_number": "914-594-4434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOGUL",
        "first_name": "HARRIETTE",
        "middle_name": "ROSEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "104864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110063317",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "WP341",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01415443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HARRIETTE",
            "last_name": "MOGUL",
            "middle_name": "ROSRN",
            "prefix": "DR.",
            "credential": "MD MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.