Oscar Javier Manrique Mogollon, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

61312 Issued in MN

Practice address

5347 Scenic Oak Dr SW
Rochester, MN 55902-2567

Phone

(617) 459-8095

NPI assigned

May 14, 2008

Last updated

Oct 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: omanrique218452@direct.urmc.rochester.edu

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.

• Syracuse Plastic Surgery, PLLC

  • Plastic Surgery Physician
  • Syracuse, NY
  • NPI 1134757891
  Medicare reassignment NPD
• Trauma Burn Emergency Surgery of the University of Rochester

  • Trauma Surgery Physician
  • Rochester, NY
  • NPI 1881886380
  Medicare reassignment NPD
• U of R Plastic Surgeons

  • Plastic Surgery Physician
  • Rochester, NY
  • NPI 1689695710
  Medicare reassignment NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment NPD
• Acute Care Trauma of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1851754634
  NPD
• Cardiac Surgery of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1689023277
  NPD
• Hematology Clinical Group

  • Hematology (Internal Medicine) Physician
  • Rochester, NY
  • NPI 1821049396
  NPD
• University of Rochester

  dba Strong Memorial Hospital-University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  dba Strong Memorial Hospital MD Group

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1538336938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5347 SCENIC OAK DR SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5347 SCENIC OAK DR SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022567",
            "telephone_number": "617-459-8095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3107 E Genesee St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132241646",
            "country_code": "US",
            "telephone_number": "315-299-5313",
            "fax_number": "315-299-5661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANRIQUE MOGOLLON",
        "first_name": "OSCAR",
        "middle_name": "JAVIER",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "109206",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "61312",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "262065",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omanrique218452@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark S Mannenbach, M.D.
• Joey Elaine Manning
• Michelle Rose Manning
• Mariana Hiromi Manoel Oku, MD
• Manor Ridge Transportation
• Bethany Mansch, PT
• Aaron S Mansfield, MD
• Brianne Mansfield, NP-C
• Ibrahim Mansoor, MBBS
• Shahd Mansour, MD

• Plastic Surgery Physician in Rochester, MN
• Providers in Rochester, MN by specialty
• Plastic Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.