DR. GRETCHEN A MOEN (DNP, APRN, CPNP) – Pediatric Nurse Practitioner, NPI 1922034933
Pediatric Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. GRETCHEN A MOEN (DNP, APRN, CPNP)
1057 GRAND AVE FL 2
SAINT PAUL, MN 551053002
Phone: (651) 384-1736
Fax: (651) 666-1507
Type: Location
2530, Horizon Drive, Burnsville, Dakota County, Minnesota, 55337, United States
BURNSVILLE, MN 553373091
Phone: (651) 209-8640
Fax: (651) 209-8690
Type: Location
4734, Westminster Circle, Eagan, Dakota County, Minnesota, 55122, United States
EAGAN, MN 551222756
Phone: (651) 456-0127
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2024-08-09 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($20).
Total Amount
$36
General + Research + Ownership
Payments
2
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $20 |
| Novo Nordisk Inc | $16 |
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: 2006-12-01
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 |
|---|---|---|---|---|
| I20061201000305 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55105)
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