Thomas Keith Mogensen, M.D.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

G079090 Issued in CA

Practice address

11955 Pendleton Rd
Yucaipa, CA 92399-4029

Phone

(909) 790-1910

NPI assigned

Nov 22, 2010

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

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.

• American Current Care of California, a Medical Corporation

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1750573622
  Medicare reassignment NPD
• Desert Valley Medical Group, Inc.

  • Physical Therapist
  • Victorville, CA
  • NPI 1639117864
  Medicare reassignment NPD
• American Current Care of California, a Medical Corporation

  • Urgent Care Clinic/Center
  • Ontario, CA
  • NPI 1811464084
  NPD
• American Current Care of California, a Medical Corporation

  • Clinic/Center
  • Richmond, CA
  • NPI 1982893988
  NPD
• Desert Valley Medical Group, Inc

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1952020315
  NPD
• Desert Valley Medical Group, Inc.

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1801848452
  NPD

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1578865671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11955 PENDLETON RD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994029",
            "telephone_number": "909-790-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11955 PENDLETON RD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994029",
            "telephone_number": "909-790-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGENSEN",
        "first_name": "THOMAS",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "G079090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashlee Miley
• Steven A Miller, O.D.
• Bonnie Kay Mills, LCSW
• Marielena Miranda
• Alexander Mogensen
• Traci Colleen Mohler, LMFT
• Florin Gabriel Moldovan, PHARMD
• Gabriel Molina, NP
• Wendy Montgomery
• Taneice Monae Mooney

• Preventive Medicine/Occupational Environmental Medicine Physician in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.