Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1003236704 Individual Practitioner Female Practitioner

Laura Woodbeck Moustafa

Pediatrics • Maple Grove, MN

Professional Overview & Biography Verified Profile Summary

Laura Moustafa is a registered healthcare professional specializing in Pediatrics in Maple Grove, MN. Practice services are available at 12720 BASS LAKE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12720 Bass Lake Rd

Maple Grove, MN 553696307

Telephone 7635592861
Associated Practice Facility / Clinic
🏢 Children's Clinic Network Facility NPI 1013278720

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Maple Grove, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.0 Yrs
State Avg: 20.6 Yrs
Regional Practice Density
30 Specialists

Practicing in Maple Grove, MN (1325 Statewide)

Telehealth Adoption Rate
20.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-05-11
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MN 61732

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners
NPI 1033186622

Doctor of Medicine (M.D.)

NPI 1063498673

Doctor of Medicine (M.D.)

NPI 1295702835

Doctor of Medicine (M.D.)

NPI 1477931152

Doctor of Medicine (M.D.)

Anmarie Oppel , PNP

Nurse Practitioner - Pediatrics

NPI 1538136643

Pediatric Nurse Practitioner

Dr. Rebecca Herrmann , DNP

Nurse Practitioner - Pediatrics

NPI 1558053561

Doctor of Nursing Practice

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
👤
Provider Name / Credentials Updated May 11, 2021

Recorded as LAURA MOUSTAFA

NPI Profile Active April 12, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 12, 2017

Registered at 12720 BASS LAKE RD, MAPLE GROVE, MN 553696307 (Tel: 7635592861)

📍
Updated Business Mailing Address April 12, 2017

Registered at 12720 BASS LAKE RD, MAPLE GROVE, MN 553696307 (Tel: 7635592861)

👤
Provider Name / Credentials Updated April 12, 2017

Recorded as LAURA WOODBECK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 12, 2017

Pediatrics (License #61732 in MN)

NPI Profile Active April 21, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location April 21, 2014

Registered at 2450 RIVERSIDE AVE, 6TH FLOOR, EAST BUILDING, MINNEAPOLIS, MN 554541450 (Tel: 6126244418)

📍
Updated Business Mailing Address April 21, 2014

Registered at 2450 RIVERSIDE AVE, 6TH FLOOR, EAST BUILDING, MINNEAPOLIS, MN 554541450 (Tel: 6126244418)

👤
Provider Name / Credentials Updated April 21, 2014

Recorded as LAURA WOODBECK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 21, 2014

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 21, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003236704
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 21, 2014
Last Update: May 11, 2021
Sole Proprietor: Yes

Mailing Address

12720 Bass Lake Rd

Maple Grove, MN 553696307

Phone: 7635592861

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.