KIMBERLY ANN MOON
NPI 1083172969
Nurse Anesthetist, Certified Registered in Fargo, ND
About Kimberly Ann Moon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY ANN MOON (NPI 1083172969) is an individual nurse anesthetist, certified registered in Fargo, North Dakota, licensed in North Dakota (R35271) and active in the NPI registry since March 2019. She is affiliated with Sanford Medical Center Fargo, maintains a secondary practice location in Fargo, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kimberly Ann Moon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kimberly Moon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fargo, ND 58103
- Reassigned Medicare billing, North Dakota enrollment
- 14 clinicians in this Medicare group
West Fargo, ND 58078
- Reassigned Medicare billing, North Dakota enrollment
- 617 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Sanford Medical Center Fargo
Acute Care Hospitals · Fargo, NDEssentia Health
Acute Care Hospitals · Fargo, NDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 58104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Moon's NPI number?
The NPI number for Kimberly Moon is 1083172969. It was assigned to this individual provider in the NPPES registry on March 9, 2019.
Where is Kimberly Moon located?
Kimberly Moon practices at 5225 23rd Ave S, Fargo, ND 58104. The listed phone number is (701) 417-2575.
What is Kimberly Moon's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kimberly Moon enrolled in Medicare?
Yes. Kimberly Moon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kimberly Moon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Moon reassigns Medicare benefits to 2 organizations: Face And Jaw Surgeons PC (Fargo, ND) and Innovis Health LLC (West Fargo, ND). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Moon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberly Moon accept?
Health plans from Blue Cross Blue Shield of North Dakota list Kimberly Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kimberly Moon affiliated with any hospitals?
According to CMS data, Kimberly Moon is affiliated with Sanford Medical Center Fargo and Essentia Health.
When was this NPI record last updated?
The NPPES record for Kimberly Moon was last updated on November 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kimberly Ann Moon · NPI 1083172969
Nurse Anesthetist, Certified Registered physician in Fargo, North Dakota. Individual provider, active in the CMS NPPES registry since March 9, 2019.
## Identity
- **NPI:** 1083172969 (Entity type: Individual)
- **Enumerated:** March 9, 2019
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** R35271 (North Dakota)
- **Sole proprietor:** No
## Practice location
- **Address:** 5225 23RD AVE S, Fargo, ND 58104-7927
- **Phone:** (701) 417-2575
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Face And Jaw Surgeons PC (NPI 1295804300, Fargo, ND); Innovis Health LLC (NPI 1487990339, West Fargo, ND) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** November 1, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1083172969) · Data from the CMS NPPES public registry.