NPIMap

Individual provider Active NPI

Steven Robert Moore, M.D.

  • Specialist
  • Saint Paul, MN
National Provider Identifier
1982678108
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
30496 Issued in MN
Practice address
1020 Bandana Blvd W
Saint Paul, MN 55108-5107
Phone
(651) 241-9700
Fax
(651) 241-9687
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 30496 MN Primary

Addresses

Primary practice location

1020 Bandana Blvd W
Saint Paul, MN 55108-5107

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 787-9729

Other practice location 1

6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Phone (651) 999-6800

Other identifiers 1

IdentifierTypeStateIssuer
922585400MedicaidMN

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
I20040216000072 MN Practitioner - Urology 5991618373 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Oregon Health Sciences University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.84 of 100Reported as group
Quality
64.59
Promoting interoperability
100
Improvement activities
40
Cost
84.88

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 1, 2010 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Allina Health System Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jan 25, 2026 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Sep 1, 2023 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Sep 1, 2023 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients

Locations

111 W Vernon Ave
Fergus Falls, MN 56537
Phone (218) 736-5770

712 S Cascade St
Fergus Falls, MN 56537

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

360 Sherman St
Ste 450
Saint Paul, MN 55102
Phone (651) 641-7100

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1020 Bandana Blvd W
Saint Paul, MN 55108
Phone (651) 641-1000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1982678108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "651-787-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BANDANA BLVD W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085107",
            "telephone_number": "651-241-9700",
            "fax_number": "651-241-9687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6025 Lake Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251710",
            "country_code": "US",
            "telephone_number": "651-999-6800",
            "fax_number": "651-999-6830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STEVEN",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "30496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922585400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.