Jill Serene Mines, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G059019 Issued in CA

Practice address

3901 Las Posas Rd
#108
Camarillo, CA 93010-1501

Phone

(805) 484-3331

Fax

(805) 484-3331

NPI assigned

Jul 10, 2006

Last updated

Dec 29, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Southern California Keck School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Dermatologists, Inc.Group PAC ID 2668525502, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Affiliated Dermatologists, Inc.

  • Dermatology Physician
  • Camarillo, CA
  • NPI 1306886429
  Medicare reassignment Care Compare group NPD
• Dignity Health

  dba St. John's Regional Medical Center

  • General Acute Care Hospital
  • Oxnard, CA
  • NPI 1073665360
  NPD (past)
• McMinnville Emergency Services LLC

  • Emergency Medicine Physician
  • McMinnville, TN
  • NPI 1689860413
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1003840869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 LAS POSAS RD",
            "address_2": "#108",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101501",
            "telephone_number": "805-484-3331",
            "fax_number": "805-484-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LAS POSAS RD",
            "address_2": "#108",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101501",
            "telephone_number": "805-484-3331",
            "fax_number": "805-484-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINES",
        "first_name": "JILL",
        "middle_name": "SERENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G059019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G297660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Miller
• Robert Francis Millhouse, M.D.
• Deena Millikin
• Grace Victoria Mills
• Sanford Jack Milner, D.P.M.
• Sandra Mintz, M.S. CCC-A
• Jacob Rod Miramontez
• Alberto Miranda
• Andrea M. Miranda
• Cristina Miranda

• Dermatology Physician in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.