Individual provider Active NPI

Sonia Coelho Mosch, PH.D.

  • Clinical Psychologist
  • Golden Valley, MN
National Provider Identifier
1356348494
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4410 Issued in MN
Practice address
4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone
(763) 588-0661
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X LP4410 MN
Clinical Psychologist 103TC0700X LP4410 MN Primary

Addresses

Primary practice location

4225 Golden Valley Rd
Golden Valley, MN 55422-4215

Mailing address

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Other practice location 1

3400 W 66th St Ste 150
Edina, MN 55435-2109
Phone (952) 920-7200

Other identifiers 1

IdentifierTypeStateIssuer
1356348494MedicaidMN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040211000784 MN Practitioner - Clinical Psychologist 9739073628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minneapolis Clinic of Neurology LTDGroup PAC ID 5496668659, 75 clinicians

Practice addresses (Care Compare)

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Merit-based Incentive Payment System (MIPS)

Final score
92.39 of 100Reported as group
Quality
84.12
Promoting interoperability
100
Improvement activities
40
Cost
83.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP4410MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Minneapolis Clinic of Neurology, LTD Clinical Neuropsychologist CurrentSince Jan 1, 2023 Accepting new patients
Laboratory Corportation of America Holdings PastSince Jan 1, 2023 Accepting new patients
Quest Diagnostics LLC Il PastSince Mar 1, 2016 Accepting new patients

Locations

3400 W 66th St
Ste 150
Minneapolis, MN 55435
Phone (952) 920-7200

4225 Golden Valley Rd
Minneapolis, MN 55422
Phone (612) 588-0661

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1356348494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224215",
            "telephone_number": "763-588-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224215",
            "telephone_number": "763-588-0661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 W 66th St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352109",
            "country_code": "US",
            "telephone_number": "952-920-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSCH",
        "first_name": "SONIA",
        "middle_name": "COELHO",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "LP4410",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356348494",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.