LAURA WOODBECK MOUSTAFA
NPI 1003236704
Pediatrics in Maple Grove, MN

Q: What is Laura Moustafa's NPI number?

The NPI number for Laura Moustafa is 1003236704. It was assigned to this individual provider in the NPPES registry on April 21, 2014.

Q: What is Laura Moustafa's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Laura Moustafa was last updated on May 11, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 21, 2014PECOS Enrolled

12720 BASS LAKE RD, MAPLE GROVE, MN 55369(763) 559-2861 Get Directions Write a Review

NPPES record last updated: May 11, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 11, 2021, Apr 12, 2017 (2 updates tracked since 2017).

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About Laura Woodbeck Moustafa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAURA WOODBECK MOUSTAFA (NPI 1003236704) is an individual pediatrics provider in Maple Grove, Minnesota, licensed in Minnesota (61732) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003236704

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameLAURA WOODBECK MOUSTAFA

Location Address12720 BASS LAKE RDMaple Grove, MN 55369-6307

Mailing Address12720 Bass Lake RdMaple Grove, MN 55369-6307 · (763) 559-2861

Phone(763) 559-2861

Sole ProprietorYes

Enumeration DateApril 21, 2014

Last NPPES UpdateMay 11, 20212 updates tracked since enumeration

NPPES CertifiedMay 11, 2021

✔ NPI 1003236704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MN · 61732

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

12720 BASS LAKE RD, Maple Grove, MN 55369

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Laura Woodbeck Moustafa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55369 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHILDREN'S CLINIC NETWORK

Clinic/Center (Primary Care)