ESSENTIA HEALTH MOOSE LAKE
NPI 1275102048
Clinic/Center - Critical Access Hospital in Moose Lake, MN

Active since June 24, 2021
4572 COUNTY ROAD 61, MOOSE LAKE, MN 55767(218) 485-2105(218) 485-2106 Get Directions Write a Review

NPPES record last updated: February 27, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 23, 2023, Dec 9, 2021, Jul 7, 2021 and 1 more (4 updates tracked since 2021).

About Essentia Health Moose Lake NPPES

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

ESSENTIA HEALTH MOOSE LAKE (NPI 1275102048), doing business as Essentia Health Moose Lake Clinic, is a healthcare organization registered as a critical access hospital in Moose Lake, Minnesota and active in the NPI registry since June 2021. The organization lists Kevin Boren, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1275102048
Entity TypeOrganization
Primary Taxonomy261QC0050X
Legal Business NameESSENTIA HEALTH MOOSE LAKE
Location Address4572 COUNTY ROAD 61Moose Lake, MN 55767-9401
Mailing Address4572 County Road 61Moose Lake, MN 55767-9401 · (218) 485-2105 · Fax (218) 485-2170
Fax(218) 485-2106
Organization SubpartYesParent: Essentia Health
Authorized OfficialKevin BorenVp Of Finance · (218) 786-1009
Enumeration DateJune 24, 2021
Last NPPES UpdateFebruary 27, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2026
✔ NPI 1275102048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Critical Access HospitalAmbulatory Health Care Facilities
Taxonomy Code261QC0050X
Definition
An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified.
4572 COUNTY ROAD 61, Moose Lake, MN 55767

Other Names 1

Doing Business AsEssentia Health Moose Lake Clinic

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Essentia Health Moose Lake is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

251

Medicare enrollment records show 251 clinicians reassign Medicare billing to Essentia Health Moose Lake, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 27

Emergency Medicine75
Nurse Practitioner45
Family Practice32
Certified Registered Nurse Anesthetist (CRNA)28
Obstetrics/Gynecology17
General Surgery6
Urology6
Anesthesiology5
19 other specialties37

Nearest to this location (20)

See all 251
Family Practice
NPI 1790165116
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 485-2105
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1184253049
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 485-2015
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1982465761
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 785-2015
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1689016354
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 485-2015
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1598768194
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 485-2105
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1083652275
4570 CTY. HWY. 61
Moose Lake, MN 55767
(218) 485-4491
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1346243961
4570 CTY. HWY. 61
Moose Lake, MN 55767
(218) 485-4491
✔ PECOS0.1 mi
Emergency Medicine
NPI 1164471108
710 S KENWOOD AVE
Moose Lake, MN 55767
(218) 485-5541
✔ PECOS0.1 mi
Nurse Practitioner
NPI 1104540012
707 LUNDORFF DR STE 1
Sandstone, MN 55072
(320) 245-2250
✔ PECOS✔ Accepts Medicare22 mi
Emergency Medicine
NPI 1962031484
705 LUNDORFF DR
Sandstone, MN 55072
(320) 245-2211
✔ PECOS✔ Accepts Medicare22 mi
Nurse Practitioner
NPI 1427905330
1413 HIGHWAY 33 S
Cloquet, MN 55720
(218) 337-4000
✔ PECOS✔ Accepts Medicare23 mi
Nurse Practitioner
NPI 1679223770
1413 HIGHWAY 33 S
Cloquet, MN 55720
(218) 337-4000
✔ PECOS✔ Accepts Medicare23 mi
Obstetrics/Gynecology
NPI 1356421929
512 SKYLINE BLVD
Cloquet, MN 55720
(218) 879-4641
✔ PECOS25 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1245758234
4572 COUNTY ROAD 61
Moose Lake, MN 55767
(218) 485-4481
✔ PECOS✔ Accepts Medicare29 mi
Family Practice
NPI 1629022397
211 S BOUNDARY AVE ESSENTIA HEALTH PROCTOR CLINIC
Proctor, MN 55810
(218) 576-0200
✔ PECOS✔ Accepts Medicare33 mi
Nurse Practitioner
NPI 1568172591
211 S BOUNDARY AVE
Proctor, MN 55810
(218) 786-8364
✔ PECOS✔ Accepts Medicare33 mi
Emergency Medicine
NPI 1851322416
407 E 3RD ST
Duluth, MN 55805
(218) 786-4000
✔ PECOS40 mi
Anesthesiology
NPI 1114260296
407 EAST THIRD STREET
Duluth, MN 55805
(218) 786-4000
✔ PECOS✔ Accepts Medicare40 mi
Interventional Pain Management
NPI 1922282458
400 E 3RD ST ESSENTIA HEALTH DULUTH CLINIC
Duluth, MN 55805
(218) 786-8364
✔ PECOS✔ Accepts Medicare40 mi
Cardiovascular Disease (Cardiology)
NPI 1841239407
400 E 3RD ST
Duluth, MN 55805
(218) 786-3443
✔ PECOS✔ Accepts Medicare40 mi
See all 251 clinicians

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

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 Essentia Health Moose Lake's NPI number?

The NPI number for Essentia Health Moose Lake is 1275102048. It was assigned to this organization in the NPPES registry on June 24, 2021. The provider is doing business as Essentia Health Moose Lake Clinic.

Where is Essentia Health Moose Lake located?

Essentia Health Moose Lake is located at 4572 County Road 61, Moose Lake, MN 55767. The listed phone number is (218) 485-2105.

What is Essentia Health Moose Lake's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Critical Access Hospital, with taxonomy code 261QC0050X.

Is Essentia Health Moose Lake enrolled in Medicare?

Yes. Essentia Health Moose Lake is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Essentia Health Moose Lake?

According to the CMS Revalidation Reassignment List (October 2026 release), 251 clinicians in 27 Medicare specialties reassign their Medicare billing to Essentia Health Moose Lake. A 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 the clinician's services. The largest specialties are Emergency Medicine (75), Nurse Practitioner (45) and Family Practice (32). Of these, 5 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Essentia Health Moose Lake accept?

Health plans from HealthPartners, Sanford Health Plan and Security Health Plan list Essentia Health Moose Lake 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.

When was this NPI record last updated?

The NPPES record for Essentia Health Moose Lake was last updated on February 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.