DR. MOJABENG PHOOFOLO (M.D.) – Hospitalist Physician, NPI 1063790392

DR. MOJABENG PHOOFOLO (M.D.) is a healthcare provider. based in Salem, Oregon. specializing in Hospitalist Physician. They hold the professional credentials M.D.. They hold a License No. 166875 (OR). The NPI Number for DR. MOJABENG PHOOFOLO (M.D.) is 1063790392

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
DR. MOJABENG PHOOFOLO (M.D.)
NPI
1063790392
Phone
(503) 561-5200
Address
890 OAK ST SE
Enumeration Date
3 August 2011
Last Update Date
30 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5035615200
Graduation Year
1998 (28 years ago)
PAC ID
5092987784
Group Practice PAC ID
8628986668
Professional Enrollment ID
I20140606000256
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for DR. MOJABENG PHOOFOLO (M.D.)

  • 890 OAK ST SE

    SALEM, OR 973013905

    Phone: (503) 561-5200

    Type: Mailing

  • 22 BRAMHALL ST

    PORTLAND, ME 041023134

    Phone: (207) 662-7068

    Type: Mailing

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: 2014-06-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140606000256IInternal MedicineORTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes23897$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes5327$0
99239Hospital discharge day management, more than 30 minutes4545$0
99238Hospital discharge day management, 30 minutes or less1414$0
View full utilization report →

Insurance plans in this area (ZIP 97301)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628986668View full group profile
NameSpecialtyState
-OR
Physician AssistantOR
U R O L O G YOR
A N E S T H E S I O L O G YWA
A N E S T H E S I O L O G YMT
Family PracticeOR
Plastic And Reconstructive SurgeryOR
A N E S T H E S I O L O G YWA
-OR
Nurse PractitionerOR

Reviews

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Frequently asked questions

How is DR. MOJABENG PHOOFOLO (M.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. MOJABENG PHOOFOLO (M.D.) with NPI 1063790392.
Does CMS list DR. MOJABENG PHOOFOLO (M.D.) as active?
Yes — DR. MOJABENG PHOOFOLO (M.D.) is active in the NPI listing used on this page.
What is DR. MOJABENG PHOOFOLO (M.D.)'s primary classification?
Hospitalist Physician is the headline specialty for DR. MOJABENG PHOOFOLO (M.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MOJABENG PHOOFOLO (M.D.)?
DR. MOJABENG PHOOFOLO (M.D.)'s geographic hint is Salem, Oregon in our summary view.
Why does DR. MOJABENG PHOOFOLO (M.D.) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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