Mauricio Sabogal, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2009-00667 Issued in NC

Practice address

705 Summit Crossing PL
Suite 150
Gastonia, NC 28054-2216

Phone

(704) 671-6300

Fax

(704) 671-6307

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Cogent Healthcare of North Carolina, PC

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1548207483
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1447309281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 SUMMIT CROSSING PL",
            "address_2": "SUITE 150",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542216",
            "telephone_number": "704-671-6300",
            "fax_number": "704-671-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SUMMIT CROSSING PL",
            "address_2": "SUITE 150",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542216",
            "telephone_number": "704-671-6300",
            "fax_number": "704-671-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABOGAL",
        "first_name": "MAURICIO",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "UO1490",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-00667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick J Russo Jr., MD
• Mystique Shavonne Rutledge
• Samantha Ann Ryan
• S & C Home Care, LLC
• Heydy Saavedra
• Angelica Burgos Saclayan, DMD
• Elizabeth H. Saez, PA
• Debra Jackson Safrit, F.N.P.
• Naphtalie Sainvil, PTA
• Nabil Peter Salameh, M.D.

• Pediatrics Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.