Individual provider Active NPI

Rebecca Ann Haefner Moore, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Madelia, MN
National Provider Identifier
1366706376
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1413 Issued in MN
Practice address
110 W Main St Ste 400
Madelia, MN 56062-1440
Phone
(507) 621-4654
Fax
(507) 528-7307
NPI assigned
Jun 25, 2012
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1413 MN Primary

Addresses

Primary practice location

110 W Main St Ste 400
Madelia, MN 56062-1440

Mailing address

PO Box 2
Madelia, MN 56062-0002
Phone (507) 621-4654

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000942 MN Practitioner - Nurse Practitioner 0749436533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 W Main St
Suite 400
Madelia, MN 56062-1440
Phone (507) 621-4654

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1413MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Hope Mental Health PLLC Psychiatric/Mental Health CurrentSince Jul 15, 2025 Accepting new patients
Madelia Health Past Accepting new patients

Locations

110 W Main St
Ste 400
Madelia, MN 56062
Phone (507) 621-4654

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1366706376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "MADELIA",
            "state": "MN",
            "postal_code": "560620002",
            "telephone_number": "507-621-4654",
            "fax_number": "507-528-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST STE 400",
            "city": "MADELIA",
            "state": "MN",
            "postal_code": "560621440",
            "telephone_number": "507-621-4654",
            "fax_number": "507-528-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "REBECCA",
        "middle_name": "ANN HAEFNER",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "1413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madelia, MN

Sources for this page

Verify at the official NPI Registry.