Individual provider Active NPI

Brad Robert Moser, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Eden Prairie, MN
National Provider Identifier
1770699555
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
44775 Issued in MN
Practice address
775 Prairie Center Dr
Suite 250
Eden Prairie, MN 55344-7314
Phone
(952) 944-2519
Fax
(952) 944-0460
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 44775 MN Primary

Addresses

Primary practice location

775 Prairie Center Dr
Suite 250
Eden Prairie, MN 55344-7314

Mailing address

6465 Wayzata Blvd
Suite 900
St Louis Park, MN 55426-1728
Phone (952) 512-5600

Other identifiers 4

IdentifierTypeStateIssuer
HP40350OtherHEALTHPARTNERS
328M7MOOtherBLUECROSS BLUESHIELD
969991031808OtherPREFERREDONE
118708OtherMEDICA

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
I20040621001158 MN Practitioner - Family Practice 4284619610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

1000 W 140TH St
Unit 201
Burnsville, MN 55337-4833
Phone (952) 808-3000

11225 Ulysses St NE
Blaine, MN 55434-4261
Phone (763) 302-2600

16800 37TH PL N
Plymouth, MN 55446-2805
Phone (763) 520-7870

2700 Vikings Cir
Eagan, MN 55121-1002
Phone (952) 456-7600

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

4100 Minnesota Dr
Edina, MN 55435-5417
Phone (952) 456-7000

5601 96TH Ave N
Brooklyn Park, MN 55443-4505
Phone (763) 786-9543

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807

820 Village Way
Waconia, MN 55387-4612

9630 Grove Cir N
Suite 200
Maple Grove, MN 55369-3492
Phone (763) 520-7870

965 Prairie Ctr Dr
Eden Prairie, MN 55344-3671

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Aug 28, 2004 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Aug 28, 2004 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

Interoperability endpoints

  • Direct secure messaging: bradmoser@tw.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1770699555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "SUITE 900",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PRAIRIE CENTER DR",
            "address_2": "SUITE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447314",
            "telephone_number": "952-944-2519",
            "fax_number": "952-944-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "BRAD",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "44775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP40350",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "328M7MO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "969991031808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "118708",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.