Daniel John Moen, MA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3320 Issued in MN

Practice address

220 N 6TH Ave E
Duluth, MN 55805-1952

Phone

(218) 249-7000

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• St. Luke'S Hospital of Duluth

  • Rehabilitation Hospital Unit
  • Duluth, MN
  • NPI 1902845068
  Medicare reassignment Care Compare group
• St. Luke'S Hospital of Duluth

  • Pediatrics Physician
  • Duluth, MN
  • NPI 1023057338
  NPD
• St. Luke'S Hospital of Duluth

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Duluth, MN
  • NPI 1073480968
  NPD

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1952352973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N 6TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051952",
            "telephone_number": "218-249-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N 6TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051952",
            "telephone_number": "218-249-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714572100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Edwin Moe, RPH
• Emily Moe
• Samantha Rene Moe, PHD
• Cara Lynn Moen, MD
• Clinton T Moen, M.D.
• Brayden Mogg, PT, DPT
• Buruj Wali Mohammed, MD
• James N Mohn, MD MPH
• Alexandra Lillian Mohror
• Robert J Mohs, D.D.S.

• Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.