NPIMap

Individual provider Active NPI

Matthew J. Mouser, MD

  • Internal Medicine Physician
  • Fergus Falls, WI
National Provider Identifier
1093767097
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50543 Issued in MN
Practice address
712 South Cascade Street
Fergus Falls, WI 56537-2813
Phone
(218) 736-8000
Fax
(218) 736-8757
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48579 WI
Internal Medicine Physician 207R00000X 50543 MN Primary

Addresses

Primary practice location

712 South Cascade Street
Fergus Falls, WI 56537-2813

Mailing address

712 South Cascade Street
Fergus Falls, WI 56537-2813
Phone (218) 736-8000

Other identifiers 1

IdentifierTypeStateIssuer
34803500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080804000570 MN Practitioner - Internal MedicinePractitioner - Hospitalist 6608897525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prairie Ridge Hospital and Health ServicesGroup PAC ID 0648222349, 90 clinicians

Practice addresses (Care Compare)

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-2221

1411 Hwy 79 E
Elbow Lake, MN 56531-4645
Phone (218) 685-7300

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

Hospital & facility affiliations

  • Vivie Hospice Hospice, Alexandria, MN, CCN 241592
  • Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379
  • Lake Region Healthcare Corporation Hospital, Fergus Falls, MN, CCN 240052
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Good Samaritan Society - Battle Lake Nursing home, Battle Lake, MN, CCN 245403
  • Pioneer Care Center Nursing home, Fergus Falls, MN, CCN 245463

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Jun 27, 2011 Accepting new patients
Lake Region Healthcare Corporation CurrentSince May 1, 2010 Accepting new patients
Lake Region Healthcare Corporation CurrentSince May 1, 2010 Accepting new patients
Lake Region Healthcare Corporation Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jun 27, 2011 Accepting new patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Good Samaritan Society - Battle LakeBattle Lake, MN, CCN 245403 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2024
Apr 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1093767097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 SOUTH CASCADE STREET",
            "city": "FERGUS FALLS",
            "state": "WI",
            "postal_code": "565372813",
            "telephone_number": "218-736-8000",
            "fax_number": "218-736-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 SOUTH CASCADE STREET",
            "city": "FERGUS FALLS",
            "state": "WI",
            "postal_code": "565372813",
            "telephone_number": "218-736-8000",
            "fax_number": "218-736-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSER",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "48579",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "50543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34803500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.