Jazmin Nicole Mogavero, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

025660 Issued in NY

Practice address

676 N Saint Clair St FL 11
Chicago, IL 60611-2954

Phone

(312) 694-7059

NPI assigned

Jun 24, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Utah Behavioral Health ServicesGroup PAC ID 9537483607, 185 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score

89.22 of 100Reported as group

Quality

83.74

Promoting interoperability

100

Improvement activities

40

Cost

66.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• University of Utah Behavioral Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1740688613
  Medicare reassignment Care Compare group NPD
• University of Utah Behavioral Health Services

  • Sports Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1740158955
  NPD
• University of Utah Behavioral Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1790149284
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697932800000",
    "number": "1386260453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST FL 11",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST FL 11",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954",
            "telephone_number": "312-694-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGAVERO",
        "first_name": "JAZMIN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "025660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmogavero653266@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Moey
• Jennifer Bridget Moffatt, DPT
• Triana Moffitt
• Pouyan Mofidi Nasab, MD
• Jonna Mogab, L.C.S.W.
• Rohan Moghe
• Michael Steven Mogil, D.D.S.
• Benjamin James Mogni V, MD
• Morteza Mohajer, M.D.
• Iman Mohajir

• Clinical Neuropsychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.