Individual provider Active NPI

Daniel Moegi, APRN, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Faribault, MN
National Provider Identifier
1508534751
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8351 Issued in MN
Practice address
400 4TH St NW Ste a
Faribault, MN 55021-5090
Phone
(507) 384-6830
Fax
(651) 431-7757
NPI assigned
Sep 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 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 8351 MN Primary

Addresses

Primary practice location

400 4TH St NW Ste a
Faribault, MN 55021-5090

Mailing address

3200 Labore Rd Ste 104
Vadnais Heights, MN 55110-5186

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
I20211105001387 MN Practitioner - Nurse Practitioner 2264821610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Dakota School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Cities ClinicGroup PAC ID 7517912991, 6 clinicians
Innovative Psychological Consultants, LLCGroup PAC ID 3678596285, 15 clinicians

Practice addresses (Care Compare)

400 4TH St NW
Faribault, MN 55021-5031
Phone (507) 384-6830

7236 Forestview LN N
Maple Grove, MN 55369-5656
Phone (763) 416-4167

Hospital & facility affiliations

  • Mayo Clinic Health System - Albert Lea and Austin Hospital, Albert Lea, MN, CCN 240043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8351MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Psychological Consultants, LLC CurrentSince Aug 29, 2022 Accepting new patients
Southern Cities Clinic CurrentSince Oct 13, 2021 Accepting new patients
Southern Cities Community Clinic PastSince Oct 13, 2021 Accepting new patients
Southern Cities Clinic PastSince Jan 4, 2026 Accepting new patients

Locations

400 4th St NW
Ste A
Faribault, MN 55021
Phone (507) 384-6830

400 4th St NW
Faribault, MN 55021
Phone (507) 384-6830

7236 Forestview Ln N
Maple Grove, MN 55369
Phone (763) 416-4167

3200 Labore Rd
Ste 104
Vadnais Heights, MN 55110
Phone (612) 387-9243

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1508534751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 LABORE RD STE 104",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 4TH ST NW STE A",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215090",
            "telephone_number": "507-384-6830",
            "fax_number": "651-431-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEGI",
        "first_name": "DANIEL",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.