Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith Fertey Moy, PASTUDENT

Individual provider Physician Assistant · NPI 1275171795

Keith Fertey Moy, PASTUDENT is a Physician Assistant in Elk River, Minnesota. Qualified in 2020, 6 years ago. Practices with Group Health Plan Inc, a 1,633-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2019
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Practice location Address checks out

530 3rd St NW
Elk River, MN 55330-1445
Phone: (763) 587-4800
Fax: (763) 587-4845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13657 (MN)

Record details

NPI number1275171795
Entity typeIndividual (Type 1)
GenderMale
Credentials PASTUDENT
Sole proprietorNo
NPI enumeratedDecember 16, 2019
Last updated in NPPESSeptember 9, 2021
Certification dateSeptember 9, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Group Health Plan Inc — 1633 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Elk River