David W Moen, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

30974 Issued in MN

Practice address

5200 Fairview Blvd
Wyoming, MN 55092-8013

Phone

(651) 982-7000

NPI assigned

Aug 31, 2006

Last updated

Apr 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urgent Care New York PC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Memphis, TN
  • NPI 1750926598
  NPD (past) Authorized official
• Teammd Physicians of Texas Inc

  • Internal Medicine Physician
  • Minnetonka, MN
  • NPI 1942708508
  NPD
• Moen, MD, PC

  dba Prospero Health Partners

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Bakersfield, CA
  • NPI 1265038681
  NPD
• Prospero Health Partners Florida, Inc

  dba Landmark Medical of Oklahoma PC

  • General Practice Physician
  • Tulsa, OK
  • NPI 1942917257
  NPD (past)
• Prospero Health Partners North Carolina, PC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1619509049
  NPD (past)
• Prospero Health Partners, P.C.

  dba Landmark Medical of Colorado

  • General Practice Physician
  • Colorado Springs, CO
  • NPI 1487361267
  NPD (past)
• Prospero Medical Services New Jersey PC

  dba LANDMARK MEDICAL OF New Jersey PC

  • General Practice Physician
  • Newark, NJ
  • NPI 1275240954
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1942312301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 S MAIN ST STE 1300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381035513",
            "telephone_number": "866-949-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8300 Norman Center Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554371050",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOEN",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "30974",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "30974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Lynn Mickelsen, REGISTERED NURSE
• Nancy Middlestead, CNP
• David A Milbrandt, MD
• Jeana Miller
• Stacey Miron
• Ravi Dhawal Moghe, DO
• Mani Mokalla, MD
• Judith M Morency, PHARM D
• Jakiann Marie Mork, ANP-BC
• Desiree Marie Morrison, PA-C

• Hospice and Palliative Medicine (Family Medicine) Physician in Wyoming, MN
• Providers in Wyoming, MN by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.