Individual provider Active NPI

Jose Flores Mogrovejo

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1205106382
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A175834 Issued in CA
Practice address
760 Westwood PLZ Ste C8-193
Los Angeles, CA 90024-5055
Phone
(424) 832-6217
NPI assigned
Jan 6, 2012
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A175834 CA Primary
Addiction Psychiatry Physician 2084P0802X A175834 CA
Child & Adolescent Psychiatry Physician 2084P0804X A175834 CA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X A175834 CA

Addresses

Primary practice location

760 Westwood PLZ Ste C8-193
Los Angeles, CA 90024-5055

Mailing address

760 Westwood PLZ Ste C8-193
Los Angeles, CA 90024-5055
Phone (424) 832-6217

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
I20250218000452 CA Practitioner - Psychiatry 2860771284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Johns Hopkins University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychbright HealthGroup PAC ID 9537533724, 9 clinicians

Practice addresses (Care Compare)

1180 S Beverly Dr
Suite 700
Los Angeles, CA 90035-1151
Phone (213) 584-2331

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psychbright Health Psychiatry CurrentSince Jan 1, 2025 Accepting new patients

Locations

9531 Santa Monica Blvd
Beverly Hills, CA 90210

1180 S Beverly Dr
Ste 700
Los Angeles, CA 90035
Phone (213) 584-2331

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1205106382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ STE C8-193",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "424-832-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ STE C8-193",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "424-832-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES MOGROVEJO",
        "first_name": "JOSE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-06",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A175834",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "A175834",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A175834",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "A175834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.