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

Q: 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.

Q: 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.

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: August 16, 2026.

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

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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

Phone(218) 485-2105

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

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Other Names 1

Doing Business AsEssentia Health Moose Lake Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan and more.Insurance ›

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.

SAMANTHA MARIE JOHNSON DPT

Physical Therapist