AMANDA M MOEN MD
NPI 1154563401
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Minneapolis, MN

Q: What is Amanda Moen's NPI number?

The NPI number for Amanda Moen is 1154563401. It was assigned to this individual provider in the NPPES registry on April 1, 2009.

Q: What is Amanda Moen's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Moen was last updated on April 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.

Active since April 01, 2009PECOS Enrolled

2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 365-6777(612) 365-8021 Get Directions Write a Review

NPPES record last updated: April 4, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Amanda M Moen Md NPPES

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

AMANDA M MOEN MD (NPI 1154563401) is an individual neurology with special qualifications in child neurology provider in Minneapolis, Minnesota, licensed in Minnesota (58414) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Paul.

NPPES Registry Identity

NPI1154563401

Entity TypeIndividualFemale

Primary Taxonomy2084N0402X

Provider Legal NameAMANDA M MOENCredential: MD

Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450

Mailing Address200 University Ave ESaint Paul, MN 55101-2507 · (651) 720-2803 · Fax (651) 229-1718

Phone(612) 365-6777

Fax(612) 365-8021

Sole ProprietorNo

Enumeration DateApril 1, 2009

Last NPPES UpdateApril 4, 2019

✔ NPI 1154563401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0402X

Licenses✔ Licensed in MN · 58414✔ Licensed in MN · 107634

Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

2450 RIVERSIDE AVE, Minneapolis, MN 55454

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Secondary Practice Location 1

Location 1200 University Ave ESaint Paul, MN 55101-2507 · Phone (651) 720-2803 · Fax (651) 229-1718

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda M Moen Md 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.

Medicare Billing Reassignments

Medicare enrollment records show Amanda Moen reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care

Same address

Clinic/Center

2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454

Reassigned Medicare billing, Minnesota enrollment
3,633 clinicians in this Medicare group

NPI 1841428745 (612) 672-6999

Fairview Specialty Services

Same address

Physical Therapy

2450 RIVERSIDE AVE
Minneapolis, MN 55454

Reassigned Medicare billing, Minnesota enrollment
2,373 clinicians in this Medicare group

NPI 1043199334 (855) 324-7843

University Of Minnesota Pediatric Dental Clinic

0.1 mi

Dentist

701 25TH AVE S, SUITE 400
Minneapolis, MN 55454

Reassigned Medicare billing, Minnesota enrollment
Medicare enrollment name: University Of Minnesota Physicians
1,453 clinicians in this Medicare group

NPI 1992075287 (651) 659-4900

University Of Minnesota Health Clinics And Surgery Center Inc

0.7 mi

Anesthesiology

909 FULTON ST SE
Minneapolis, MN 55455

Reassigned Medicare billing, Minnesota enrollment
1,662 clinicians in this Medicare group

NPI 1003485004 (612) 273-8383

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 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

$127.61 typical visit price

range $56.00 – $168.28

Typical copayment $31.90 (range $14.00 – $42.07)

Most-billed visit code 99204

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.

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.

MICHELLE IRENE GRAY

Rehabilitation Practitioner