Alexander Earl Moses

Primary specialty

OptometristTaxonomy code 152W00000X

License

3400 Issued in MN

Practice address

1027 Washington Ave
Detroit Lakes, MN 56501-3409

Phone

(218) 847-5611

Fax

(218) 847-0881

NPI assigned

Oct 19, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
• Essentia Health Hospital, Fargo, ND, CCN 350070

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Marys Regional Health Center

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088

  Optometrist

  Medicare reassignment Care Compare group NPD
• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• St Mary'S Regional Health Center

  • Family Medicine Physician
  • Detroit Lakes, MN
  • NPI 1639513377
  NPD
• St Mary'S Regional Health Center

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482
  NPD
• Innovis Health LLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576

  Optometrist

  NPD
• Innovis Health, LLC.

  • Family Medicine Physician
  • Jamestown, ND
  • NPI 1073793725
  NPD
• St Marys Regional Health Center

  • Multi-Specialty Clinic/Center
  • Park Rapids, MN
  • NPI 1730731464
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary'S Regional Health Center

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482

  Hospital

  Care Compare affiliation
• St Marys Regional Health Center

  • Rural Health Clinic/Center
  • Park Rapids, MN
  • NPI 1730706656

  Hospital

  Care Compare affiliation
• St. Marys Regional Health Center

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Care Compare affiliation
• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1063797116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-847-5611",
            "fax_number": "218-847-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-847-5611",
            "fax_number": "218-847-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "ALEXANDER",
        "middle_name": "EARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3400",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "727",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063797116",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayli Marie Mollberg, PT
• Angela Jean Moothart, RN
• Manuel R. Moran, M.D.
• Morrison Eye Care Optometrists, P.a.
• Megan Morrison
• Kurtis K Motschenbacher, PA-C
• Brenda K Muckenhirn, PT
• Collette Kay Murphy
• Anna Muzik
• Beth Marie Neitzel, MS, CCC-SLP

• Optometrist in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.