Active NPI
Alissa M Moen, PA-C
- Physician Assistant
- Tea, SD
National Provider Identifier
1073546156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0584
- Practice address
- 2120 Live Stronger St
Tea, SD 57064-8331 - Phone
- (605) 331-5890
- NPI assigned
- Jul 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0584 | SD | Primary |
Addresses
Primary practice location
2120 Live Stronger St
Tea, SD 57064-8331
Mailing address
2120 Live Stronger St
Tea, SD 57064-8331
Phone (605) 331-5890
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00227328 | Other | SD | RAILROAD MEDICARE |
| 682750 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD, MN, IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1101 Broadway Ave
Yankton, SD 57078-2835
Phone (605) 331-5890
1300 S Burr St
Mitchell, SD 57301-4551
Phone (605) 331-5890
2120 Live Stronger St
Tea, SD 57064-8331
Phone (605) 331-5890
810 E 23Rd St
Sioux Falls, SD 57105-2135
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.01 of 100
- Quality
- 78.63
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 64.73
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- alissa.moen.1@21545.direct.athenahealth.com
Organizations & group practices 1
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.
Hospital & facility affiliations 24
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
-
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1184834764
-
- Endocrinology, Diabetes & Metabolism Physician
- Sioux Falls, SD
- NPI 1396711016
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1073546156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 LIVE STRONGER ST",
"city": "TEA",
"state": "SD",
"postal_code": "570648331",
"telephone_number": "605-331-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 LIVE STRONGER ST",
"city": "TEA",
"state": "SD",
"postal_code": "570648331",
"telephone_number": "605-331-5890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEN",
"first_name": "ALISSA",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SD",
"license": "0584",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00227328",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "682750",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tea, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.