Individual provider Active NPI

Deborah Anne Mogelof, M.D.

  • Emergency Medicine Physician
  • Westport, CT
National Provider Identifier
1821255589
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
046539 Issued in CT
Practice address
5 Breezy KNLS
Westport, CT 06880-1201
Phone
(203) 293-4803
NPI assigned
May 20, 2008
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 046539 CT Primary

Addresses

Primary practice location

5 Breezy KNLS
Westport, CT 06880-1201

Mailing address

5 Breezy KNLS
Westport, CT 06880-1201
Phone (203) 293-4803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20080719000002 CT Practitioner - Emergency Medicine 6608949987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westport Urgent Care LLCGroup PAC ID 4688826712, 7 clinicians

Practice addresses (Care Compare)

1045 Post E Rd
Westport, CT 06880-5370
Phone (203) 557-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
046539CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westport Urgent Care LLC CurrentSince Oct 16, 2012 Accepting new patients
Emergency Medicine Physicians of Fairfield County, LLC Emergency Medicine Past Accepting new patients

Locations

1045 Post Rd E
Westport, CT 06880
Phone (203) 259-2124

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

484 Temple Hill Rd
Ste 104
New Windsor, NY 12553
Phone (732) 896-4444

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1821255589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BREEZY KNLS",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068801201",
            "telephone_number": "203-293-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BREEZY KNLS",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068801201",
            "telephone_number": "203-293-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGELOF",
        "first_name": "DEBORAH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "046539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.