Jordan J Moen, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8819 Issued in MN

Practice address

1400 Madison Ave Ste 100Aa
Mankato, MN 56001-5465

Phone

(507) 385-2600

NPI assigned

Nov 10, 2011

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, 658 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoen90512@ehrdirect.mayoclinicmsg.org

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

• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System-Waseca

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1083991558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 100AA",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015465",
            "telephone_number": "507-385-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 100AA",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015465",
            "telephone_number": "507-385-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "JORDAN",
        "middle_name": "J",
        "credential": "DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-10",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoen90512@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Madison Ave Ste 100Aa",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560015465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• MN State Colleges and Universities (MSU Student Health Services)
• Modern Dental Professionals Minnesota PC (Midwest Dental)
• Michael L Moeller, MD
• Caitlin Moen, M.S.
• Daniel Alfred Moen, LMFT
• Ismahan Osman Mohamed
• Rahma Osman Mohamed
• Satyajit Mohite, M.D., M.P.H.
• Anthony Jerome Moldan, D.C.
• Andrea Noelle Moldstad, DNP, APRN, FNP-C

• Physical Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.