Individual provider Active NPI

Michael T Mosher, M.D.

  • Allergy Physician
  • Thousand Oaks, CA
National Provider Identifier
1053417865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
A62252 Issued in CA
Practice address
415 Rolling Oaks Dr
Suite 280
Thousand Oaks, CA 91361-1029
Phone
(805) 496-8522
Fax
(805) 496-0469
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X A62252 CA Primary

Addresses

Primary practice location

415 Rolling Oaks Dr
Suite 280
Thousand Oaks, CA 91361-1029

Mailing address

415 Rolling Oaks Dr
Suite 280
Thousand Oaks, CA 91361-1029
Phone (805) 496-8522

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
I20040518000966 CA Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 2769472018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Albany Medical College of Union University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michael T Mosher M.D a Medical CorporationGroup PAC ID 3678563921, 2 clinicians

Practice addresses (Care Compare)

415 Rolling Oaks Dr
Suite 280
Thousand Oaks, CA 91361-1049
Phone (805) 496-8522

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A62252CAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael T Mosher M.D a Medical Corporation CurrentSince Jul 1, 2002 Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
West Hills Hospital Past Accepting new patients

Locations

2876 Sycamore Dr
Ste 301
Simi Valley, CA 93065
Phone (805) 306-0304

415 Rolling Oaks Dr
Ste 280
Thousand Oaks, CA 91361
Phone (805) 496-8522

Organizations & group practices 4

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053417865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DR",
            "address_2": "SUITE 280",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611029",
            "telephone_number": "805-496-8522",
            "fax_number": "805-496-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DR",
            "address_2": "SUITE 280",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611029",
            "telephone_number": "805-496-8522",
            "fax_number": "805-496-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHER",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "A62252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.