Dr Thomas Keith Mogensen, MD is a medicare enrolled "Preventive Medicine - Preventive Medicine/occupational Environmental Medicine" physician in Yucaipa, California. His current practice location is
11955 Pendleton Rd, Yucaipa, California. You can reach out to his office (for appointments etc.) via phone at
(909) 790-1910.
Dr Thomas Keith Mogensen is licensed to practice in California (license number G079090) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578865671.
Physician's Profile
| Full Name | Dr Thomas Keith Mogensen |
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| Gender | Male |
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| Speciality | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine |
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| Location | 11955 Pendleton Rd, Yucaipa, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578865671
- Provider Enumeration Date: 11/22/2010
- Last Update Date: 11/22/2010
Medicare PECOS Information:
- PECOS PAC ID: 4587938436
- Enrollment ID: I20170915003184
Medical Identifiers
Medical identifiers for Dr Thomas Keith Mogensen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578865671 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | G079090 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Thomas Keith Mogensen allows following entities to bill medicare on his behalf.
| Entity Name | Desert Valley Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1639117864
PECOS PAC ID: 4880595875
Enrollment ID: O20040113000803 |
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| Entity Name | American Current Care Of California A Medical Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750573622
PECOS PAC ID: 5799854303
Enrollment ID: O20080522000420 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Thomas Keith Mogensen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Thomas Keith Mogensen, MD
11955 Pendleton Rd,
Yucaipa, CA 92399-4029
Ph: (909) 790-1910 | Dr Thomas Keith Mogensen, MD
11955 Pendleton Rd,
Yucaipa, CA 92399-4029
Ph: (909) 790-1910 |
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