NPIMap

Individual provider Active NPI

Nefeli Anna Moutsoglou, DNP, NP-C

  • Nurse Practitioner
  • St Louis Park, MN
National Provider Identifier
1992216022
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5488 Issued in MN
Practice address
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone
(952) 993-3400
NPI assigned
Oct 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5488 MN Primary

Addresses

Primary practice location

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 532-9661

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
I20180111001499 MN Practitioner - Nurse Practitioner 4688933948 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5488MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Tyler CurrentSince Oct 30, 2019 Accepting new patients
Rural Health Care, Inc CurrentSince Jan 1, 2022 Accepting new patients
Avera Marshall CurrentSince Nov 2, 2017 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Avera Marshall CurrentSince Nov 2, 2017 Accepting new patients
Avera Marshall Current Accepting new patients
Avera Tyler CurrentSince Oct 30, 2019 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 9, 2022 Accepting new patients
Rural Health Care, Inc CurrentSince Jan 1, 2022 Accepting new patients
Rural Health Care, Inc Nurse Practitioner Current Accepting new patients
Avera Tyler Current Accepting new patients

Locations

9555 Upland Ln N
Maple Grove, MN 55369
Phone (952) 993-1440

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

300 S Bruce St
Ste 100
Marshall, MN 56258

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Interoperability endpoints

  • Direct secure messaging: nefeli.moutsoglou@avera.sdhealthlink.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1992216022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Bruce St",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MN",
            "postal_code": "562581934",
            "country_code": "US",
            "telephone_number": "507-532-9661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUTSOGLOU",
        "first_name": "NEFELI",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "5488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.