BROOKE A MOSS (NPI# 1316346950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316346950 |
| Entity Type | Individual |
| Full Name | BROOKE A MOSS |
| Other Name | BROOKE A STEIN |
| Credential | PA-C |
| Practice Address |
4100 W 50th St Edina MN 55424 |
| Mailing Address |
2 Carlson Pkwy N Ste 240 Plymouth MN 55447-4485 |
| Practice Telephone | 9529298888 |
| Practice Fax Number | 9529299669 |
| Mailing Telephone | 7637460030 |
| Mailing Fax Number | 7633677977 |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2018-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 11856 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | H400272686 | 05 |
| Street Address |
4100 W 50TH ST |
| City | EDINA |
| State | MN |
| Zip Code | 55424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629175617 | Zel Skin & Laser Specialists, LLC | Clinic/Center | 4100 W 50th St, Edina, MN 55424-1200 | 2006-09-20 |
| 1861861759 | United Skin Specialists, Ltd | Dermatology | 4100 W 50th St, Edina, MN 55424-1200 | 2015-09-21 |
| 1730323304 | Elisabeth Hurliman | Dermatology | 4100 W 50th St, Edina, MN 55424-1200 | 2009-04-27 |
| 1639335441 | Lund Food Holdings, Inc. | Pharmacist | 4100 W 50th St, Edina, MN 55424-1200 | 2008-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154824084 | Jamie Bradley | Midwife | 6240 Peacedale Avenue, Edina, MN 55424 | 2018-03-16 |
| 1467987313 | Lisa Sorensen | Psychologist | 5200 Willson Road, #445, Edina, MN 55424 | 2017-04-28 |
| 1093049348 | Harry Alvin Johnson Jr. | Plastic Surgery | 4708 Townes Road, Edina, MN 55424 | 2009-09-18 |
| 1396935219 | Michele Frances Dodds | Psychologist | 3948 West 50th St, #207, Edina, MN 55424 | 2007-07-26 |
| 1245452168 | Margo Ellen Arens | Physical Therapist | 6025 St. John's Ave., Edina, MN 55424 | 2007-05-02 |
| 1215095435 | Kristie J Anderson | Nurse Practitioner | 6905 York Ave S, Edina, MN 55424 | 2006-12-04 |
| 1821199852 | Michael T Kratz Dds Pa | Dentist | 3939 W 50th Street, #208, Edina, MN 55424 | 2006-09-25 |
| 1649747114 | Elizabeth Davin | Physician Assistant | 6905 York Ave S, Edina, MN 55424 | 2018-11-01 |
| 1245606326 | Forefront Dermatology, S.c. | Dermatology | 3916 W 50th St, Edina, MN 55424 | 2015-08-12 |
| 1083789929 | Edina 5-o Dental Pa | Dentist | 3948 W 50th St, Suite 205, Edina, MN 55424 | 2006-11-22 |
| Find all providers in zip 55424 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033756168 | Chandler R Hutton | Physician Assistant | 6550 York Ave S Ste 112, Edina, MN 55435-2332 | 2019-12-09 |
| 1619529369 | Mh 101, PC | Physician Assistant | 6801 Washington Ave S Ste 100, Edina, MN 55439-1523 | 2019-07-12 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1346676319 | Catherine Anne Cecconi | Physician Assistant | 6545 France Ave S Ste 586, Edina, MN 55435 | 2013-09-22 |
| 1255619813 | Evan M Burgart | Physician Assistant | 6363 France Ave S Ste 400, Edina, MN 55435-2130 | 2011-08-01 |
| 1962737981 | Melissa Faye Hall | Physician Assistant | 6363 France Avenue South, Suite 400, Edina, MN 55435 | 2009-10-08 |
| 1588825145 | Bennett Ezra Goltz | Physician Assistant | 6363 France Ave S Ste 103, Edina, MN 55435 | 2008-06-17 |
| 1013105907 | Maisy Monica Sanneman | Physician Assistant | 6525 France Ave. S., Suite 200, Edina, MN 55435 | 2007-10-05 |
| 1699701672 | Sarah Teresa Bot | Physician Assistant | 6525 France Ave South, Suite 100, Edina, MN 55435-3624 | 2006-06-23 |
| 1336108224 | J Robert Noel IIi | Physician Assistant | Fairview Geriatric Services, 7505 Metro Blvd Suite 100, Edina, MN 55439 | 2006-03-21 |
| Find all providers in EDINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.