Brooke Alexandra Stein Moss, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11856 Issued in MN

Practice address

21410 136TH Ave Ste 105a
Rogers, MN 55374-4921

Phone

(763) 515-6200

Fax

(763) 515-6202

NPI assigned

Aug 20, 2014

Sex

Female

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 1

Other names 1

• Brooke A Stein Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brooke.moss@forefrontdermatology.emadirect.md

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Lakeville, MN
  • NPI 1659747731
  Medicare reassignment Care Compare group
• Oral and Maxillofacial Surgical Consultants PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Chanhassen, MN
  • NPI 1316165012
  Medicare reassignment
• Forefront Dermatology, S.C.

  • Plastic Surgery Physician
  • Minneapolis, MN
  • NPI 1528951035
  NPD
• Oral and Maxillofacial Surgical Consultants PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Edina, MN
  • NPI 1619049921
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Crutchfield Dermatology, P.a.

  • Dermatology Physician
  • Eagan, MN
  • NPI 1962426502
  NPD (past)
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1316346950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21410 136TH AVE STE 105A",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744921",
            "telephone_number": "763-515-6200",
            "fax_number": "763-515-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "BROOKE",
        "middle_name": "ALEXANDRA STEIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H400272686",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Brooke.Moss@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "21410 136th Ave Ste 105A",
            "city": "Rogers",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553744921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "STEIN",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Rogers, MN
• Providers in Rogers, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.