Individual provider Active NPI

Mark Jeffrey Mogul, M.D.

  • Pediatric Hematology & Oncology Physician
  • Orlando, FL
National Provider Identifier
1336113752
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
ME121139 Issued in FL
Practice address
92 W Miller St
Orlando, FL 32806-2032
Phone
(218) 418-5883
Fax
(321) 841-8560
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G068539 CA
Pediatric Hematology & Oncology Physician 2080P0207X ME121139 FL Primary

Addresses

Primary practice location

92 W Miller St
Orlando, FL 32806-2032

Mailing address

92 W Miller St
Orlando, FL 32806-2032
Phone (218) 418-5883

Other practice location 1

2550 Sister Mary Columba Dr
Red Bluff, CA 96080-4327
Phone (813) 295-1505

Other identifiers 1

IdentifierTypeStateIssuer
111952500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MT, WA, WI, CA, MO, GA7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20141029001845 FL Practitioner - Hematology/Oncology 0042244972 Reassigns benefits to 1 organization
I20220505002547 MT Practitioner - Pediatric Medicine 0042244972 Reassigns benefits to 1 organization
I20230224002143 WA Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 0042244972 Reassigns benefits to 1 organization
I20231213002267 WI Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 0042244972 Reassigns benefits to 9 organizations
I20241024004407 CA Practitioner - Pediatric Medicine 0042244972 Reassigns benefits to 1 organization
Practice locations: Red Bluff, CA
I20260325001637 MO Practitioner - Hematology/Oncology 0042244972 Reassigns benefits to 1 organization
I20260619001022 GA Practitioner - Pediatric Medicine 0042244972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

2401 Gillham Rd
Kansas City, MO 64108-4619

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G068539CAMDPediatrics Physician
ME121139FLMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Dec 27, 2023 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Memorial Hospital Inc CurrentSince Dec 27, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 27, 2023 Accepting new patients
Benefis Hospitals, Inc. CurrentSince Jan 23, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 27, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Memorial Hospital Inc CurrentSince Dec 27, 2023 Accepting new patients
Benefis Hospitals Inc CurrentSince Jan 23, 2024 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Seattle Childrens Hospital CurrentSince Jan 21, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 27, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2021 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 27, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 27, 2023 Accepting new patients
Orlando Health Medical Group Inc Pediatrics CurrentSince Oct 1, 2021 Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 27, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 27, 2023 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients
Egleston Children'S Hospital at Emory University, Inc. Past Accepting new patients

Locations

92 W Miller St
Fl 2
Orlando, FL 32806
Phone (321) 841-2245

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: mmogul295523@orlandohealth.medalliesdirect.net

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1336113752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "218-418-5883",
            "fax_number": "321-841-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "218-418-5883",
            "fax_number": "321-841-8560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Sister Mary Columba Dr",
            "address_purpose": "LOCATION",
            "city": "Red Bluff",
            "state": "CA",
            "postal_code": "960804327",
            "country_code": "US",
            "telephone_number": "813-295-1505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOGUL",
        "first_name": "MARK",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G068539",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "FL",
            "license": "ME121139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111952500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.