| Andrew Moen, DPM | |
|
1027 Washington Ave, Detroit Lakes, MN 56501-3409 | |
| (218) 847-5611 | |
| (218) 847-0881 |
| Full Name | Andrew Moen |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 17 Years |
| Location | 1027 Washington Ave, Detroit Lakes, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073843587 | NPI | - | NPPES |
| 1073843587 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | TP-169 (Minnesota) | Secondary |
| 213E00000X | Podiatrist | 844 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health St Marys - Detroit Lakes | Detroit lakes, MN | Hospital |
| Essentia Health Fosston | Fosston, MN | Hospital |
| Sanford Medical Center Fargo | Fargo, ND | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Marys Regional Health Center | 2062326820 | 158 |
| First Care Medical Services | 3678542842 | 16 |
| Provider Name | St Marys Regional Health Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1679561088 PECOS PAC ID: 2062326820 Enrollment ID: O20031117000090 |
| Provider Name | First Care Medical Services |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073638565 PECOS PAC ID: 3678542842 Enrollment ID: O20040927000035 |
| Provider Name | Bridges Medical Center |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1366886186 PECOS PAC ID: 4981659851 Enrollment ID: O20050809000114 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Moen, DPM 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611 | Andrew Moen, DPM 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611 |
Dr. Benjy Olsen, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 188-475-6112 | |
Andrew J Johnson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1245 S Washington Ave, Detroit Lakes, MN 56501 Phone: 218-846-2000 Fax: 218-846-2114 |