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RENZO MOGOLLON MD
NPI 1356090617
Internal Medicine - Geriatric Medicine in Boston, MA

Active since March 22, 2022PECOS Enrolled
72 E CONCORD ST # 2700, BOSTON, MA 02118(617) 638-6178 Get Directions Write a Review

NPPES record last updated: July 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Renzo Mogollon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENZO MOGOLLON MD (NPI 1356090617) is an individual geriatric medicine provider in Boston, Massachusetts, licensed in Massachusetts (3017846) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Reno.

NPPES Registry Identity

NPI1356090617
Entity TypeIndividualMale
Primary Taxonomy207RG0300X
Provider Legal NameRENZO MOGOLLONCredential: MD
Location Address72 E CONCORD ST # 2700Boston, MA 02118-2642
Mailing Address745 W Moana Ln Ste 300Reno, NV 89509-4980 · (775) 327-5174
Phone(617) 638-6178
Sole ProprietorNo
Enumeration DateMarch 22, 2022
Last NPPES UpdateJuly 4, 2025
NPPES CertifiedJuly 4, 2025
✔ NPI 1356090617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in MA · 3017846
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
72 E CONCORD ST # 2700, Boston, MA 02118
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Secondary Practice Location 1

Location 1745 W Moana Ln Ste 300Reno, NV 89509-4980 · Phone (775) 327-5174

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Renzo Mogollon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$189.86 typical visit price
range $63.72 – $189.86
Typical copayment $47.46 (range $15.93 – $47.46)
Most-billed visit code 99205
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renzo Mogollon's NPI number?

The NPI number for Renzo Mogollon is 1356090617. It was assigned to this individual provider in the NPPES registry on March 22, 2022.

Where is Renzo Mogollon located?

Renzo Mogollon practices at 72 E Concord St # 2700, Boston, MA 02118. The listed phone number is (617) 638-6178.

What is Renzo Mogollon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Renzo Mogollon enrolled in Medicare?

Yes. Renzo Mogollon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Renzo Mogollon was last updated on July 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.