Jessica Lee Moore, LICSW in Roseville, MN - Medicare Social Worker Provider

Jessica Lee Moore, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Roseville, Minnesota. Her current practice location is 2700 Snelling Ave N Ste 400, Roseville, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 210-4698.

Jessica Lee Moore is licensed to practice in Minnesota (license number 29099) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750002929.

Contact Information

	Jessica Lee Moore, LICSW
	2700 Snelling Ave N Ste 400, Roseville, MN 55113-1783
	(763) 210-4698
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jessica Lee Moore
Gender	Female
Speciality	Social Worker - Clinical
Location	2700 Snelling Ave N Ste 400, Roseville, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750002929
Provider Enumeration Date: 09/07/2022
Last Update Date: 11/28/2023

Medicare PECOS Information:

PECOS PAC ID: 4789030545
Enrollment ID: I20231031000443

Medical Identifiers

Medical identifiers for Jessica Lee Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750002929	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	29099 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Lee Moore allows following entities to bill medicare on her behalf.

Entity Name	Fairview Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461

Entity Name	Healtheast Medical Research Institute
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507

Entity Name	Fairview Express Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Lee Moore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jessica Lee Moore, LICSW 3116 Emerson Ave S Apt 3, Minneapolis, MN 55408-2774 Ph: (763) 458-6143	Jessica Lee Moore, LICSW 2700 Snelling Ave N Ste 400, Roseville, MN 55113-1783 Ph: (763) 210-4698

Reviews and Comments

Social Worker in Roseville, MN

Andrea Mccormick, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2277 Highway 36 W Ste 310, Roseville, MN 55113 Phone: 651-252-7755 Fax: 612-331-3520
Lisa M Borneman, DSW, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2233 Hamline Ave N Ste 512, Roseville, MN 55113 Phone: 651-690-6721
Jean Gregg, LICSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 2233 Hamline Ave N Ste 435, Roseville, MN 55113 Phone: 651-216-1935
Errin Marie Musich, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2277 Highway 36 W Ste 160, Roseville, MN 55113 Phone: 763-575-8086
Cimena Gordon, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2277 Highway 36 W, Suite 310, Roseville, MN 55113 Phone: 651-224-2172
Samantha Oren, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2700 Snelling Ave N Ste 400, Roseville, MN 55113 Phone: 763-210-4698
Laura Lyman, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2700 Snelling Ave N Ste 400, Roseville, MN 55113 Phone: 763-525-9919 Fax: 763-486-4436

Jessica Lee Moore, LICSW - Medicare Clinical Social Worker in Roseville, MN