Jacob Minor, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4068 Issued in WV

Practice address

3100 Maccorkle Ave SE Ste 700
Charleston, WV 25304-1230

Phone

(304) 351-1600

Fax

(304) 351-1604

NPI assigned

Mar 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, WI2 enrollments

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 2

Specialty

General Surgery

Education

West Virginia School of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Surgical Associates of Neenah, S.C.Group PAC ID 4486625258, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
• Thedacare Medical Center - Berlin Inc Hospital, Berlin, WI, CCN 521355

Merit-based Incentive Payment System (MIPS)

Final score

90.94 of 100Reported as apm

Quality

69.71

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Surgical Associates of Neenah, S.C.

  • Surgery Physician
  • Neenah, WI
  • NPI 1285792341
  Medicare reassignment Care Compare group NPD
• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Ripon, WI
  • NPI 1326493602
  Care Compare affiliation
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  Care Compare affiliation
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Wautoma, WI
  • NPI 1992159289
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1023472842
  Care Compare affiliation
• Thedacare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Menasha, WI
  • NPI 1720434806
  Care Compare affiliation
• Thedacare Regional Medical Center-Neenah, Inc.

  • General Acute Care Hospital
  • Neenah, WI
  • NPI 1518993880
  Care Compare affiliation
• Thedacare Regional Medical Center-Neenah, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1861943409
  Care Compare affiliation
• Thedcare Regional Medical Center - Neenah, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1679937494
  Care Compare affiliation

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1033613930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-647-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 700",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041230",
            "telephone_number": "304-351-1600",
            "fax_number": "304-351-1604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3110 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041210",
            "country_code": "US",
            "telephone_number": "304-388-9948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-647-6006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINOR",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "4068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Minenko-McDaniel, MD
• Heather Miner
• Jovon Minimah-Beane
• Susan Marrash Minnerly
• Susan Minnich
• Sherry Tenise Minter-Elliott
• Mary Katlyn Minton, DS
• Susan Mirra
• Muqtadir A Mirza, M.D.
• Mina Mirzakhani

• Surgery Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.