Active NPI
Jeffrey E Moghina, PHARM.D., BCPS
- Pharmacotherapy Pharmacist
- Phoenix, AZ
National Provider Identifier
1164727616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 3121291
- Practice address
- 650 E Indian School Rd
Attn: Outpatient Pharmacy
Phoenix, AZ 85012-1839 - Phone
- (602) 277-5551
- NPI assigned
- Jan 13, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0012650 | OR | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | S018261 | AZ | |
| Pharmacotherapy Pharmacist | 1835P1200X | 3121291 | AZ | Primary |
Addresses
Primary practice location
650 E Indian School Rd
Attn: Outpatient Pharmacy
Phoenix, AZ 85012-1839
Mailing address
5640 W Tonopah Dr
Glendale, AZ 85308-9106
Phone (602) 277-5551
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S018261 | Other | AZ | REGISTERED PHARMACIST LICENSE |
| 3121291 | Other | BCPS BOARD OF PHARMACY SPECIALTIES | |
| 0012650 | Other | OR | REGISTERED PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0012650 | OR | MD | Pharmacist |
| S018261 | AZ | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 3121291 | AZ | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1164727616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5640 W TONOPAH DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853089106",
"telephone_number": "602-277-5551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E INDIAN SCHOOL RD",
"address_2": "ATTN: OUTPATIENT PHARMACY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121839",
"telephone_number": "602-277-5551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHINA",
"first_name": "JEFFREY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PHARM.D., BCPS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-13",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "0012650",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "AZ",
"license": "S018261",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "AZ",
"license": "3121291",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST LICENSE",
"identifier": "S018261",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCPS BOARD OF PHARMACY SPECIALTIES",
"identifier": "3121291",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST LICENSE",
"identifier": "0012650",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.