Dr Connie Kalal Moe, PSYD, LP is a medicare enrolled "Psychologist - Clinical" provider in Staples, Minnesota. She graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Lakewood Health System and her current practice location is
49725 County 83, Staples, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 894-8852.
Dr Connie Kalal Moe is licensed to practice in Minnesota (license number LP6061) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1629245469.
Healthcare Provider's Profile
| Full Name | Dr Connie Kalal Moe |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 10 Years |
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| Location | 49725 County 83, Staples, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Connie Kalal Moe graduated from medical school in 2014
NPI Data:
- NPI Number: 1629245469
- Provider Enumeration Date: 05/12/2008
- Last Update Date: 02/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 0648550962
- Enrollment ID: I20161202001198
Medical Identifiers
Medical identifiers for Dr Connie Kalal Moe such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1629245469 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | LP6061 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Lakewood Health System | 1052229671 | 78 |
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. Dr Connie Kalal Moe allows following entities to bill medicare on her behalf.
| Entity Name | Lakewood Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841280823
PECOS PAC ID: 1052229671
Enrollment ID: O20031104000411 |
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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. Dr Connie Kalal Moe 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 |
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Dr Connie Kalal Moe, PSYD, LP
49725 County 83,
Staples, MN 56479-5280
Ph: (218) 894-1515 | Dr Connie Kalal Moe, PSYD, LP
49725 County 83,
Staples, MN 56479-5280
Ph: (218) 894-8852 |
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