Mojabeng Phoofolo, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

166875 Issued in OR

Practice address

22 Bramhall St
Portland, ME 04102-3175

Phone

(336) 407-2998

NPI assigned

Aug 3, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment NPD
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  Medicare reassignment NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD
• Cogent Healthcare of Illinois, LLC

  • Internal Medicine Physician
  • Quincy, IL
  • NPI 1487897849

  Hospitalist

  NPD (past)
• Cogent Healthcare of Montana P C

  • Internal Medicine Physician
  • Missoula, MT
  • NPI 1053569525

  Hospitalist

  NPD (past)

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1063790392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175",
            "telephone_number": "336-407-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOOFOLO",
        "first_name": "MOJABENG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "166875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Wendell Phillips, DDS
• Katherine Read Phillips, LCSW
• Rachel S Phillips, MS, OTR
• Stephanie G Phillips, M.A., J.D., LMFT
• Adi Michelle Philpott, DO
• Physical and Functional Medicine Incorporated
• Physical Rehabilitation of Southern Maine PC
• Bernadeth Lyn Cal Piamonte, MD
• Gretchen A. Pianka, M.D.
• Michelle Anne Picard, CRNA

• Hospitalist Physician in Portland, ME
• Providers in Portland, ME by specialty
• Hospitalist Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.