Michael L Moeller, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

39584 Issued in MN

Practice address

600 Reed St
Suite 115
Mankato, MN 56001-6410

Phone

(507) 625-4060

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in SD, MN2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

East Central Mental Health and Chemical Dependency CenterGroup PAC ID 5890787105, 3 clinicians

Omni Solutions LLCGroup PAC ID 6709293541, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Omni Solutions LLC

  • Marriage & Family Therapist
  • Mankato, MN
  • NPI 1215523477
  Medicare reassignment Care Compare group NPD
• East Central Mental Health & Chemical Dependency Center

  • Community/Behavioral Health Agency
  • Brookings, SD
  • NPI 1699820316
  Medicare reassignment Care Compare group NPD
• Sanford Health Network

  • Family Medicine Physician
  • Tracy, MN
  • NPI 1699869875
  Medicare reassignment NPD
• Dakota Counseling Institute, Inc.

  • Mental Health Counselor
  • Mitchell, SD
  • NPI 1760542278
  Medicare reassignment NPD
• Sanford Health Network

  • Critical Access Hospital
  • Vermillion, SD
  • NPI 1790721280
  Medicare reassignment
• Sanford Health Network

  • Rural Health Clinic/Center
  • Jackson, MN
  • NPI 1083638357
  NPD
• Sanford Health Network

  • Rural Health Clinic/Center
  • Mountain Lake, MN
  • NPI 1568469039
  NPD
• Sioux Trails Mental Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Ulm, MN
  • NPI 1902909914

  Psychiatry

  NPD
• Sanford Health Network

  • Family Medicine Physician
  • Vermillion, SD
  • NPI 1013921733
  NPD
• Bethesda Christian Counseling Midwest, Inc.

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1376522060
  NPD (past)
• Community Counseling Service

  • Mental Health Counselor
  • Huron, SD
  • NPI 1932167277
  NPD (past)
• Creative Living Center, P.C.

  • Counselor
  • Rock Valley, IA
  • NPI 1609807098
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1598765877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 REED ST",
            "address_2": "SUITE 115",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016410",
            "telephone_number": "507-625-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 REED ST",
            "address_2": "SUITE 115",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016410",
            "telephone_number": "507-625-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "39584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP24849",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "531214100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE OF MINNESOTA",
            "identifier": "122727D113",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "359J1MO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miracle Ear
• Miracle Ear
• Artika Misra, M.D.
• MN State Colleges and Universities
• Modern Dental Professionals Minnesota PC
• Caitlin Moen, M.S.
• Daniel Alfred Moen, LMFT
• Jordan J Moen, DPT, OCS
• Ismahan Osman Mohamed
• Rahma Osman Mohamed

• Psychiatry Physician in Mankato, MN
• Providers in Mankato, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.