Mark A Moen, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

441 Issued in ND

Practice address

404 Hwy 2 East
Devils Lake, ND 58301-0130

Phone

(701) 662-4085

Fax

(701) 662-6685

NPI assigned

Sep 15, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS Moen Enderle and Krein PCGroup PAC ID 9638072440, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DRS Moen Enderle and Krein PC

  • Optometrist
  • Devils Lake, ND
  • NPI 1265539639
  Medicare reassignment Care Compare group NPD Authorized official
• DRS Moen Enderle and Krein PC

  dba 20/20 EyeCare

  • Optometrist
  • Devils Lake, ND
  • NPI 1598944373

  Corneal and Contact Management

  NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1124124623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583010130",
            "telephone_number": "701-662-4085",
            "fax_number": "701-662-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 HWY 2 EAST",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583010130",
            "telephone_number": "701-662-4085",
            "fax_number": "701-662-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "ND",
            "license": "441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS SAFETY AND COMP",
            "identifier": "450433379000",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND VISION SERVICES",
            "identifier": "800441",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF NORTH DAKOTA",
            "identifier": "8844",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "CI2649",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE SERVICE",
            "identifier": "0311120001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60342",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Nicole Miller
• Louise Mitzel
• Amber Gayle Moen
• Carol Sue Moen, NURSE PRACTITIONER
• Dorothy Elizabeth Moen
• Russell Moen
• Sheila Moen
• Roberto A. Moraleda, M.D.
• Kerry Morin
• Courtney Morken

• Corneal and Contact Management Optometrist in Devils Lake, ND
• Providers in Devils Lake, ND by specialty
• Corneal and Contact Management Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.