Kandyce Moen, OTR is a medicare enrolled "Occupational Therapist" provider in Chisago City, Minnesota. Her current practice location is
10069 Stacy Trl, Chisago City, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(763) 689-5385.
Kandyce Moen is licensed to practice in Minnesota (license number 100563) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1295827590.
Healthcare Provider's Profile
| Full Name | Kandyce Moen |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 10069 Stacy Trl, Chisago City, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1295827590
- Provider Enumeration Date: 09/28/2006
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 3274447198
- Enrollment ID: I20150605000434
Medical Identifiers
Medical identifiers for Kandyce Moen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295827590 | NPI | - | NPPES |
| 05G60MO | Other | MN | BCBS |
| HP45836 | Other | MN | HEALTH PARTNERS |
| 6402785 | Other | MN | MEDICA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225X00000X | Occupational Therapist | 100563 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kandyce Moen allows following entities to bill medicare on her behalf.
| Provider Name | Functional Integrated Therapy, Ltd |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1477640613
PECOS PAC ID: 9234189879
Enrollment ID: O20050131001036 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kandyce Moen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kandyce Moen, OTR
10069 Stacy Trl,
Chisago City, MN 55013-9531
Ph: () - | Kandyce Moen, OTR
10069 Stacy Trl,
Chisago City, MN 55013-9531
Ph: (763) 689-5385 |
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