Individual provider Active NPI

John C Mogab, MD

  • Anesthesiology Physician
  • Denver, CO
National Provider Identifier
1396722492
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20241 Issued in CO
Practice address
191 University Blvd
#713
Denver, CO 80206-4613
Phone
(303) 377-6825
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20241 CO Primary

Addresses

Primary practice location

191 University Blvd
#713
Denver, CO 80206-4613

Mailing address

191 University Blvd
#713
Denver, CO 80206-4613
Phone (303) 377-6825

Other identifiers 8

IdentifierTypeStateIssuer
84113438513MedicaidNE
907490200MedicaidFL
118748100MedicaidWY
3506685MedicaidMT
431593700MedicaidME
01202415MedicaidCO
54727758MedicaidNM
100459020AMedicaidKS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20241COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Anesthesia Consultants, P.C. Anesthesiology Past Accepting new patients
US Anesthesia Partners of Colorado Inc. Anesthesiology PastSince Apr 23, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1396722492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 UNIVERSITY BLVD",
            "address_2": "#713",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064613",
            "telephone_number": "303-377-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 UNIVERSITY BLVD",
            "address_2": "#713",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064613",
            "telephone_number": "303-377-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGAB",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "20241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84113438513",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907490200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118748100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3506685",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431593700",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01202415",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54727758",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100459020A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.