Individual provider Active NPI

Jennifer D. Ceynar Moen, FNP

  • Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1649298720
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R27188 Issued in ND
Practice address
300 N 7TH St
Bismarck, ND 58501-4439
Phone
(701) 323-6000
Fax
(701) 323-5918
NPI assigned
Jul 17, 2006
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R27188 ND Primary

Addresses

Primary practice location

300 N 7TH St
Bismarck, ND 58501-4439

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other identifiers 2

IdentifierTypeStateIssuer
4305386MedicaidMT
10969MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omaha Therapy IncGroup PAC ID 1557270915, 68 clinicians

Practice addresses (Care Compare)

683 State Ave
Dickinson, ND 58601-4660
Phone (701) 483-9400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck Current Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients
Sanford Bismarck CurrentSince Feb 19, 2019 Accepting new patients
Sanford Bismarck CurrentSince Feb 19, 2019 Accepting new patients
Comprehensive Pediatric Care, P. C. Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

222 N 7th St
Bismarck, ND 58501
Phone (701) 323-5422

300 N 7th St
Bismarck, ND 58501
Phone (701) 323-6153

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

Organizations & group practices 7

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.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1649298720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEYNAR MOEN",
        "first_name": "JENNIFER",
        "middle_name": "D.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R27188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4305386",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10969",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.