Jacqueline Brogan, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A160890 Issued in CA

Practice address

230 Prospect PL Ste 260
Coronado, CA 92118

Phone

(619) 437-1146

NPI assigned

May 2, 2015

Last updated

Feb 25, 2020By 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 2

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

Dermatology

Education

University of Texas Medical School at San Antonio, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Charlene V Kakimoto MD IncGroup PAC ID 4880940956, 3 clinicians

William F Resh MD Skin and Skin Cancer Medical Group of San Diego IncGroup PAC ID 4082601935, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

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

• William F Resh MD, Skin & Skin Cancer Medical Group of San Diego, Inc.

  dba San Diego Family Dermatology

  • Specialist
  • National City, CA
  • NPI 1790973162

  Dermatology

  Medicare reassignment Care Compare group NPD
• Charlene V. Kakimoto, MD, Inc

  • Clinical & Laboratory Dermatological Immunology Physician
  • Coronado, CA
  • NPI 1083104012
  Medicare reassignment Care Compare group
• Jacqueline Brogan MD

  • Dermatology Physician
  • Coronado, CA
  • NPI 1326603028
  NPD Authorized official
• D.a. Lopez, MD

  • Clinical & Laboratory Dermatological Immunology Physician
  • Coronado, CA
  • NPI 1306935200
  NPD
• William F Resh M.D. Skin & Skin Cancer Medical Group of San Diego, Inc

  dba San Diego Family Dermatology

  • Dermatology Physician
  • San Diego, CA
  • NPI 1831938232
  NPD
• William F Resh M.D. Skin & Skin Cancer Medical Group of San Diego, Inc

  • Dermatology Physician
  • El Cajon, CA
  • NPI 1912186917
  NPD

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

• Sharp Coronado Hospital and Healthcare Center

  dba Sharp Coronado Hospital

  • General Acute Care Hospital
  • Coronado, CA
  • NPI 1154304475
  Care Compare affiliation

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1801273479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PROSPECT PL STE 260",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181987",
            "telephone_number": "619-437-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PROSPECT PL STE 260",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "92118",
            "telephone_number": "619-437-1146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Prospect Pl Ste 260",
            "address_purpose": "LOCATION",
            "city": "Coronado",
            "state": "CA",
            "postal_code": "92118",
            "country_code": "US",
            "telephone_number": "619-437-1146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 Euclid Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "National City",
            "state": "CA",
            "postal_code": "919502978",
            "country_code": "US",
            "telephone_number": "619-267-8303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-02",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A160890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Morgan Bogle, FNP
• Obel Borrajero
• Sandra Jill Boyce, MFT
• Johan Merle Brandl Amundson, PT, DPT
• Janeza Bridges, RD
• Wanda L. Brothers, MFT, S.E.P
• Mitchell Brown, OD
• Han Nguyen Bui, PHARM.D.
• Jessica Burley, FNP
• Kimberly Byers-Lund, D.O.

• Dermatology Physician in Coronado, CA
• Providers in Coronado, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.