Individual provider Active NPI

Gary A. Moody, M.D.

  • Family Medicine Physician
  • Hastings, MN
National Provider Identifier
1356310148
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22698 Issued in MN
Practice address
1285 Nininger Rd
Hastings, MN 55033-1086
Phone
(651) 480-4200
Fax
(651) 480-4306
NPI assigned
Mar 15, 2006
Last updated
Jul 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22698 MN Primary

Addresses

Primary practice location

1285 Nininger Rd
Hastings, MN 55033-1086

Mailing address

1285 Nininger Rd
Hastings, MN 55033-1086
Phone (651) 480-4200

Other identifiers 10

IdentifierTypeStateIssuer
30229200OtherMNMEDICAID WI
760387800MedicaidMN
472S5M0OtherMNBLUE CROSS
66-07826OtherMNMEDICA URGENT CARE
080194898OtherMNRAILROAD MEDICARAE
102582OtherMNUCARE MINNESOTA
NA9140186005OtherMNPREFERRED ONE
01-11650OtherMNMEDICA
30229200OtherMNGROUP HEALTH EAU CLAIRE
HP11055OtherMNHEALTH PARTNERS

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006000881 MN Practitioner - Family Practice 6406741495 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 528-6999

13819 Hanson Blvd NW
Andover, MN 55304-7608
Phone (612) 626-5775

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

1700 University Ave W
Saint Paul, MN 55104-3727

1875 Woodwinds Dr
Woodbury, MN 55125-2298
Phone (651) 232-6800

1925 Woodwinds Dr
Woodbury, MN 55125-4445
Phone (651) 232-0100

2945 Hazelwood St
Suite 100
Maplewood, MN 55109-1242
Phone (651) 232-7800

3305 Central Park Village Dr
Eagan, MN 55121-7707
Phone (651) 406-8860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
88.69
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22698MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Apr 1, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jan 18, 2012 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 16, 2020 Accepting new patients
Fairview Clinics CurrentSince Aug 20, 2008 Accepting new patients
Healtheast Medical Research Institute Family Medicine CurrentSince Mar 16, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Apr 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Aug 20, 2008 Accepting new patients
Regina Medical Center Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: gmoody56615@fairview.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 2

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1356310148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 NININGER RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331086",
            "telephone_number": "651-480-4200",
            "fax_number": "651-480-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 NININGER RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331086",
            "telephone_number": "651-480-4200",
            "fax_number": "651-480-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "GARY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "22698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WI",
            "identifier": "30229200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "760387800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "472S5M0",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA URGENT CARE",
            "identifier": "66-07826",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARAE",
            "identifier": "080194898",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "102582",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9140186005",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-11650",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH EAU CLAIRE",
            "identifier": "30229200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP11055",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MN

Sources for this page

Verify at the official NPI Registry.