Individual provider Active NPI

Peter Moises Falcon, LPCC

  • Professional Counselor
  • Otsego, MN
National Provider Identifier
1508212812
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2052 Issued in MN
Practice address
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone
(763) 746-9492
Fax
(763) 746-3685
NPI assigned
May 5, 2016
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10678 NE
Mental Health Counselor 101YM0800X 2052 MN
Professional Counselor 101YP2500X 2052 MN Primary

Addresses

Primary practice location

9245 Quantrelle Ave NE
Otsego, MN 55330-0168

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

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
I20240110002423 MN Practitioner - Mental Health Counselor 9638520026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone (763) 746-9492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10678NEMDMental Health Counselor
2052MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Nystrom & Associates, LTD CurrentSince Sep 8, 2025 Accepting new patients
Family Support Services Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Ellie Family Services, PLLP CurrentSince Jan 1, 2024 Accepting new patients

Locations

207 Jefferson Blvd
Big Lake, MN 55309
Phone (763) 367-6080

10729 Town Square Dr NE
Ste 120
Blaine, MN 55449
Phone (763) 343-9010

11660 Round Lake Blvd NW
Coon Rapids, MN 55433
Phone (763) 317-0718

13603 80th Cir N
Maple Grove, MN 55369
Phone (763) 274-3120

7767 Elm Creek Blvd N
Ste 220
Maple Grove, MN 55369
Phone (612) 516-5660

7767 Elm Creek Blvd N
Ste 220240
Maple Grove, MN 55369

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 764-7245

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 307-5148

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Interoperability endpoints

  • Direct secure messaging: peterfalcon@tdh.allscriptsdirect.net

Organizations & group practices 4

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": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1508212812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 QUANTRELLE AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553300168",
            "telephone_number": "763-746-9492",
            "fax_number": "763-746-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCON",
        "first_name": "PETER",
        "middle_name": "MOISES",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10678",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2052",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Otsego, MN

Sources for this page

Verify at the official NPI Registry.