Dr Maryam Lee Moghaddam, DO - Medicare Obstetrics/gynecology in Maple Grove, MN

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Dr Maryam Lee Moghaddam, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Maple Grove, Minnesota. She went to University Of Iowa, Rj & L Carver College Of Medicine and graduated in 1984 and has 41 years of diverse experience with area of expertise as Obstetrics/gynecology. She is a member of the group practice Fairview Express Care, Fairview Clinics and her current practice location is 14500 99th Ave N, Maple Grove, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 898-1000.

Dr Maryam Lee Moghaddam is licensed to practice in Minnesota (license number 31579) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1811958424.

Contact Information

Dr Maryam Lee Moghaddam, DO
14500 99th Ave N,
Maple Grove, MN 55369-4730
(763) 898-1000
Not Available

Map and Direction




Physician's Profile

Full NameDr Maryam Lee Moghaddam
GenderFemale
SpecialityObstetrics/gynecology
Experience41 Years
Location14500 99th Ave N, Maple Grove, Minnesota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Maryam Lee Moghaddam attended and graduated from University Of Iowa, Rj & L Carver College Of Medicine in 1984
  NPI Data:
  • NPI Number: 1811958424
  • Provider Enumeration Date: 03/31/2006
  • Last Update Date: 02/07/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 2769674803
  • Enrollment ID: I20101007001343

Medical Identifiers

Medical identifiers for Dr Maryam Lee Moghaddam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811958424NPI-NPPES
309397200MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 31579 (Minnesota)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Fairview Express Care33756451791733
Fairview Clinics7113830142736

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. Dr Maryam Lee Moghaddam allows following entities to bill medicare on her behalf.
Entity NameFairview Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461
Entity NameFairview Clinics
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346432218
PECOS PAC ID: 7113830142
Enrollment ID: O20031106000516
Entity NameFairview Express Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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. Dr Maryam Lee Moghaddam 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 AddressPractice Location Address
Dr Maryam Lee Moghaddam, DO
16973 Weaver Lake Dr,
Maple Grove, MN 55311-1435

Ph: (612) 670-5214		Dr Maryam Lee Moghaddam, DO
14500 99th Ave N,
Maple Grove, MN 55369-4730

Ph: (763) 898-1000

Reviews and Comments


Obstetrics & Gynecology Doctors in Maple Grove, MN

Kathryn G Flory, MD
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 9825 Hospital Dr Ste 300, Maple Grove, MN 55369
Phone: 763-587-7900    Fax: 763-494-7501
Christine Suzanne Goudge Walker, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 15800 95th Ave N, Park Nicollet - Dept Of Ob/gyn, Maple Grove, MN 55369
Phone: 952-993-3282    
Katie Corcoran, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 9825 Hospital Dr Ste 300, Maple Grove, MN 55369
Phone: 763-587-7900    Fax: 763-494-7501
Dr. Sarah A Wernimont, M.D., PH.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 14500 99th Ave N, Maple Grove, MN 55369
Phone: 763-898-1000    
Dr. Brigette Beth Ritter, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 15800 95th Ave N, Park Nicollet Maple Grove, Maple Grove, MN 55369
Phone: 952-993-3282    Fax: 952-993-1425
Kristin M Lyerly, M.D.
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 9855 Hospital Dr, Maple Grove, MN 55369
Phone: 952-993-3282    
Leslee J Jaeger, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 9875 Hospital Dr, Maple Grove, MN 55369
Phone: 763-581-1100    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.