NPIMap

Individual provider Active NPI

Mark John Moe, M.D.

  • Internal Medicine Physician
  • Little Falls, MN
National Provider Identifier
1902821937
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
46385 Issued in MN
Practice address
811 2ND St SE Ste a
Little Falls, MN 56345-3505
Phone
(320) 631-7000
NPI assigned
Jul 12, 2006
Last updated
Jul 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 46385 MN Primary

Addresses

Primary practice location

811 2ND St SE Ste a
Little Falls, MN 56345-3505

Mailing address

811 2ND St. SE
Suite a
Little Falls, MN 56345

Other identifiers 8

IdentifierTypeStateIssuer
779460600MedicaidMN
2145399OtherAMERICA'S PPO
132024C736OtherMNUCARE MINNESOTA
HP43143OtherHEALTH PARTNERS
NA9231041286OtherPREFERRED ONE
0406746OtherMEDICA
879S1MOOtherMNBCBS OF MINNESOTA
A031OtherMNTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000956 MN Practitioner - Internal Medicine 0547247736 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Minnesota Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, 69 clinicians
Unity Family HealthcareGroup PAC ID 9830003516, shared by 7 NPIs, 65 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

200 1St Ave SE
Pierz, MN 56364-4138
Phone (320) 468-2536

815 2ND St SE
Little Falls, MN 56345-3505
Phone (320) 632-5441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46385MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District CurrentSince Feb 1, 2025 Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Unity Family Healthcare CurrentSince Jan 1, 2010 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Glacial Ridge Hospital District CurrentSince Feb 1, 2025 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Unity Family Healthcare CurrentSince Jan 1, 2010 Accepting new patients
Unity Family Healthcare Physician Services PastSince Aug 1, 2004 Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients
Unity Family Healthcare Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

811 2nd St SE
Ste A
Little Falls, MN 56345
Phone (320) 631-7000

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c
  • Direct secure messaging: mmoe196298@direct.centracare.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CHI Health at HomeLittle Falls, MN, CCN 247279 Home health agency Contracted Managing Employee Apr 4, 2024
CHI Health at HomeLittle Falls, MN, CCN 241542 Hospice Corporate Director
Operational/Managerial Control		 Mar 3, 2024
Mar 3, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1902821937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 2ND ST. SE",
            "address_2": "SUITE A",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "56345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 2ND ST SE STE A",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453505",
            "telephone_number": "320-631-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "MARK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "46385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "779460600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "2145399",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "132024C736",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP43143",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9231041286",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0406746",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MINNESOTA",
            "identifier": "879S1MO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A031",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, MN

Sources for this page

Verify at the official NPI Registry.