Individual provider Active NPI

Erin Moga, MD

  • Family Medicine Physician
  • Fort Leavenworth, KS
National Provider Identifier
1497731798
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101238791 Issued in VA
Practice address
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone
(913) 684-6623
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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 0101238791 VA Primary

Addresses

Primary practice location

550 Pope Ave
Fort Leavenworth, KS 66027-2332

Mailing address

550 Pope Ave
Fort Leavenworth, KS 66027-2332
Phone (913) 684-6623

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
I20160107000411 MN Practitioner - Family Practice 6103128244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

4181 108TH Ave NE
Blaine, MN 55449-7439
Phone (651) 430-3800

480 Osborne Rd NE
Suite 100
Fridley, MN 55432-2781
Phone (763) 581-2273

8559 Edinbrook Pkwy
Suite 100
Brooklyn Park, MN 55443-3728
Phone (763) 581-2273

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101238791VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Mar 1, 2020 Accepting new patients
North Memorial Health Care Current Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

11855 Ulysses St NE
Ste 110
Blaine, MN 55434
Phone (763) 235-4104

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

480 Osborne Rd NE
Ste 100
Minneapolis, MN 55432
Phone (763) 785-4500

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: emoga127870@direct.northmemorial.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1497731798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGA",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.