Modern Ketamine Clinic in Maple Grove, MN

Modern Ketamine Clinic is a medicare enrolled primary clinic (Clinic/center - Infusion Therapy) in Maple Grove, Minnesota. The current practice location for Modern Ketamine Clinic is 13792 Reimer Dr N, Maple Grove, Minnesota. For appointments, you can reach them via phone at (763) 347-2100. The mailing address for Modern Ketamine Clinic is 13792 Reimer Dr N, Maple Grove, Minnesota and phone number is (763) 347-2100.

Modern Ketamine Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1386366532. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (763) 347-2100.

Contact Information

	Modern Ketamine Clinic
	13792 Reimer Dr N Maple Grove MN 55311-2219
	(763) 347-2100
	(763) 333-7174

Map and Direction

Primary Care Clinic Profile

Full Name	Modern Ketamine Clinic
Speciality	Clinic/Center
Location	13792 Reimer Dr N, Maple Grove, Minnesota
Authorized Official Name and Position	Daniel Gregory Falvey (MD)
Authorized Official Contact	7633472100
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Modern Ketamine Clinic 13792 Reimer Dr N Maple Grove MN 55311-2219 Ph: (763) 347-2100	Modern Ketamine Clinic 13792 Reimer Dr N Maple Grove MN 55311-2219 Ph: (763) 347-2100

NPI Details:

NPI Number	1386366532
Provider Enumeration Date	09/14/2022
Last Update Date	10/18/2022

Medicare PECOS Information:

Medicare PECOS PAC ID	1951778877
Medicare Enrollment ID	O20221107001896

Medical Identifiers

Medical identifiers for Modern Ketamine Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386366532	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QM1300X	Clinic/center - Multi-specialty	(* (Not Available))	Secondary
261QI0500X	Clinic/center - Infusion Therapy	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Modern Ketamine Clinic acts as a billing entity for following providers:

Provider Name	Daniel Falvey
Provider Type	Practitioner - Emergency Medicine
Provider Identifiers	NPI Number: 1003194085 PECOS PAC ID: 3678798758 Enrollment ID: I20161207000024

Reviews and Comments

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Modern Ketamine Clinic - Medicare Primary Care in Maple Grove, MN