Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jared Mogul, PA-C

Individual provider Physician Assistant · NPI 1407733520

Jared Mogul, PA-C is a Physician Assistant in Stony Brook, New York. Licensed in New York. Registered with an NPI since 2025.

Licensed in
NY
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

101 Nicolls Rd
Stony Brook, NY 11794-8200
Phone: (631) 444-2252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)

Record details

NPI number1407733520
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 20, 2025
Last updated in NPPESOctober 12, 2025
Certification dateOctober 12, 2025

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