DR. MARYAM LEE MOGHADDAM (DO) – Obstetrics & Gynecology Physician, NPI 1811958424
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
822 OBSTETRICS/GYNECOLOGY in MN
Loading map...
Provider Addresses for DR. MARYAM LEE MOGHADDAM (DO)
16973, Weaver Lake Drive North, Pond Hollow, Maple Grove, Hennepin County, Minnesota, 55311, United States
MAPLE GROVE, MN 553111435
Phone: (612) 670-5214
Type: Mailing
M Health Fairview Clinics and Surgery Center - Maple Grove, 14500, 99th Avenue North, Maple Grove, Hennepin County, Minnesota, 55369, United States
MAPLE GROVE, MN 553694730
Phone: (763) 898-1000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-10-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101007001343 | I | Obstetrics/Gynecology | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 3,096 | 30 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 42 | 36 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 39 | 28 | $0 |
| 73562 | X-ray of knee, 3 views | 32 | 26 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 28 | 26 | $0 |
Insurance plans in this area (ZIP 55311)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | MN | |
| Family Practice | MN | |
| Family Practice | IL | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| - | MN |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.