Dimitrios N Minadakis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1916 Issued in MN

Practice address

495 Station Ave
South Yarmouth, MA 02664-1218

Phone

(774) 552-3208

Fax

(320) 202-8949

NPI assigned

Jul 5, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dminadakis110732@direct.centracare.com

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.

• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665
  Medicare reassignment Care Compare group NPD (past)
• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  Medicare reassignment NPD
• Centracare Clinic

  • Sleep Disorder Diagnostic Clinic/Center
  • St Cloud, MN
  • NPI 1295910727
  NPD
• Centracare Clinic

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • Hudson, WI
  • NPI 1568840916
  NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Joseph, MN
  • NPI 1134121759
  NPD (past)
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)

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

• St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Care Compare affiliation
• St. Cloud Hospital

  • Mental Health Counselor
  • Sartell, MN
  • NPI 1083161814

  Hospital

  Care Compare affiliation
• St. Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1841502929
  Care Compare affiliation
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  Care Compare affiliation

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1063852085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 JANICE RD",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026642935",
            "telephone_number": "320-291-3184",
            "fax_number": "320-291-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 STATION AVE",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026641218",
            "telephone_number": "774-552-3208",
            "fax_number": "320-202-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINADAKIS",
        "first_name": "DIMITRIOS",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "1916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063852085",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in South Yarmouth, MA
• Providers in South Yarmouth, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.