Chisom Mogbo, DO

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A22898 Issued in CA

Practice address

1250 Broadway
Sonoma, CA 95476-7500

Phone

(949) 371-9773

NPI assigned

Mar 24, 2020

Last updated

Sep 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physical Medicine and Rehabilitation

Education

Philadelphia College of Osteopathic Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael Decker DO, Inc.Group PAC ID 9830481746, 23 clinicians

Kyaw Lin DO IncGroup PAC ID 7113420027, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael Decker, DO, Inc

  • Skilled Nursing Facility
  • Hermosa Beach, CA
  • NPI 1528410842
  Medicare reassignment Care Compare group NPD
• Kyaw Lin, DO Inc

  • Physical Medicine & Rehabilitation Physician
  • Walnut Creek, CA
  • NPI 1639064850
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1447887120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BROADWAY",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BROADWAY",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767500",
            "telephone_number": "949-371-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGBO",
        "first_name": "CHISOM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A22898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Lynn Meyer, MD
• Peter G. Meyerhof, D.D.S.
• Steven Don Mickelson, PA
• Ronald Frederick Miller, DDS
• Subhash Mishra, MD
• Melinda Jane Moore, FNP
• Jim Morein
• Jana Morgan, LCSW
• Anatoliy S Moroz, FNP
• Christy Murphy, PHARMD

• Physical Medicine & Rehabilitation Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.