Individual provider Active NPI

Rebecca L. Mogensen, NP

  • Nurse Practitioner
  • Madison, WI
National Provider Identifier
1063700839
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4539 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-0001
Phone
(608) 263-6400
NPI assigned
Jul 14, 2011
Last updated
Jan 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4539 WI Primary
Nurse Practitioner 363L00000X 157263 WI

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-0001

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122001777 MA Practitioner - Nurse Practitioner 8729259114 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
157263WIMDNurse Practitioner
4539WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 7, 2016 Accepting new patients
Brigham and Women's Faulkner Hospital Inc Current Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

1153 Centre St
#L1
Jamaica Plain, MA 02130

Interoperability endpoints

  • Direct secure messaging: mogensen.rebecca.fh@direct.partners.masshiway.net

Organizations & group practices 3

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": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1063700839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGENSEN",
        "first_name": "REBECCA",
        "middle_name": "L.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4539",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "157263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.