Elijah Mobley, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

CA286A Issued in CA

Practice address

15366 11TH St Ste Q
Victorville, CA 92395-3726

Phone

(760) 241-6201

Fax

(760) 241-6203

NPI assigned

Feb 23, 2006

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

Other identifiers 1

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

General Surgery

Education

Meharry Medical College School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Wound MD PC

  • General Practice Physician
  • Petaluma, CA
  • NPI 1942606744
  Medicare reassignment NPD
• Elijah Mobley MD Incorporated

  • Surgery Physician
  • Victorville, CA
  • NPI 1013247485
  Medicare reassignment
• Dignity Health

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)
• San Dimas Community Hospital, Inc.

  • Skilled Nursing Facility
  • San Dimas, CA
  • NPI 1568487619
  NPD (past)
• Prime Healthcare Services - Reno LLC

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1801152566
  NPD (past)

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

• St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186
  Care Compare affiliation

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1528034212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20258 US HIGHWAY 18",
            "address_2": "PMB 514 STE 430",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923076197",
            "telephone_number": "760-946-0100",
            "fax_number": "760-946-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15366 11TH ST STE Q",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953726",
            "telephone_number": "760-241-6201",
            "fax_number": "760-241-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "ELIJAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-10-02",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "SD",
            "license": "5725",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "CA286A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6631230",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mission City Community Network Inc.
• Mission City Community Network, Inc.
• Melvin Douglas Mitchell Jr., PMHNP
• Raynisha Lauraine Mitchell
• Erika Moberg
• Rezah Shoval Mohamed, D.O
• Mojave Chiropractic
• Mojave Dental Center
• Mojave Desert Hearing Aid Center
• Mojave Valley Physical Therapy

• Surgery Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.