Active NPI
Joseph Moriarty, MD
- Family Medicine Physician
- Baxter, MN
National Provider Identifier
1780662007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 40765
- Practice address
- 13060 Isle Dr
Baxter, MN 56425-8331 - Phone
- (218) 828-2880
- NPI assigned
- Jan 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 40765 | MN | Primary |
Addresses
Primary practice location
13060 Isle Dr
Baxter, MN 56425-8331
Mailing address
523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 640018300 | Medicaid | MN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050221000597 | MN | Practitioner - Family Practice | 8123071917 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13060 Isle Dr
Baxter, MN 56425-8331
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40765 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph'S Medical Center | Current | Accepting new patients | |
| Brainerd Medical Center Inc. | Current | Accepting new patients | |
| Brainerd Medical Center Inc | Current | Accepting new patients | |
| St Joseph'S Medical Center | Current | Accepting new patients | |
| St Joseph'S Medical Center | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394
13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920
2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Good Samaritan Society - Hospice | Hospice | Contracted Managing Employee | Jan 1, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Nisswa, MN
- NPI 1740293083
Contracted Managing Employee
Organizations & group practices 6
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.
-
- General Practice Physician
- Brainerd, MN
- NPI 1295801777
-
- Clinic Pharmacy
- Staples, MN
- NPI 1972350486
-
- Multi-Specialty Clinic/Center
- Staples, MN
- NPI 1538916101
-
- Clinic/Center
- Brainerd, MN
- NPI 1952896144
-
- General Acute Care Hospital
- Brainerd, MN
- NPI 1568415974
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brainerd, MN
- NPI 1568415974
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Brainerd, MN
- NPI 1740393032
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1780662007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 N 3RD ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564013054",
"telephone_number": "218-829-2861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13060 ISLE DR",
"city": "BAXTER",
"state": "MN",
"postal_code": "564258331",
"telephone_number": "218-828-2880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIARTY",
"first_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-06",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "40765",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "640018300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baxter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.