Matthew Minarik, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006700 Issued in MI

Practice address

7750 Town Centre Dr Ste 300
Broadview Heights, OH 44147-4040

Phone

(877) 283-8863

NPI assigned

Nov 7, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bow Tie Medical Ohio, LLC

  • General Practice Physician
  • Broadview Heights, OH
  • NPI 1811328065
  NPD (past)
• Mark a. Lang, M.D., LLC

  • Family Medicine Physician
  • Broadview Heights, OH
  • NPI 1528301488
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1003245341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 TOWN CENTRE DR STE 300",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441474040",
            "telephone_number": "877-238-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 TOWN CENTRE DR STE 300",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441474040",
            "telephone_number": "877-283-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINARIK",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-07",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056138",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006700",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006700",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004059",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112106",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Eugene McNair, NP
• Sarah Grace Michalak, PA-C
• Elaine Milanich, RPH
• Brian Joseph Miles, DC
• Bryn Miller
• Miracle City Hospice, LLC
• Gina Mitchner
• Joseph Mithell
• MMS Emergency Physicians Inc
• Julie Koutsoulias Montemarano, DC

• Physician Assistant in Broadview Heights, OH
• Providers in Broadview Heights, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.