ELIJAH MOBLEY (M.D.) – Surgery Physician, NPI 1528034212
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,317 GENERAL SURGERY in CA
Provider Addresses for ELIJAH MOBLEY (M.D.)
15366 11TH ST STE Q
VICTORVILLE, CA 923953726
Phone: (760) 241-6201
Fax: (760) 241-6203
Type: Location
Apple Valley Post Office, 22099, Outer Highway 18 South, Apple Valley, San Bernardino County, California, 92307, United States
PMB 514 STE 430
APPLE VALLEY, CA 923076197
Phone: (760) 946-0100
Fax: (760) 946-3176
Type: Mailing
15247, 11th Street, Victorville, San Bernardino County, California, 92395, United States
STE 100
VICTORVILLE, CA 923953727
Phone: (760) 241-6201
Fax: (760) 241-6203
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2003-11-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20031119000929 | I | General Surgery | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92395)
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