Individual provider Active NPI

Una Clare Miniter, M.D.

  • Dermatology Physician
  • Moline, IL
National Provider Identifier
1073879128
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036160480 Issued in IL
Practice address
600 John Deere Rd Ste 200
Moline, IL 61265-6897
Phone
(309) 779-4200
Fax
(309) 779-4305
NPI assigned
Apr 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD176337 OR
Dermatology Physician 207N00000X 036160480 IL Primary

Addresses

Primary practice location

600 John Deere Rd Ste 200
Moline, IL 61265-6897

Mailing address

600 John Deere Rd Ste 200
Moline, IL 61265-6897
Phone (309) 779-4200

Other identifiers 1

IdentifierTypeStateIssuer
500659596MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address uminiter868549@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, IL2 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

Enrollment IDStateProvider typePAC IDDetails
I20161010001067 OR Practitioner - Dermatology 1850526187 Reassigns benefits to 1 organization
I20220729002857 IL Practitioner - Dermatology 1850526187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Loyola University of Chicago, Stritch School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Arts Associates, LTD.Group PAC ID 4385549377, 19 clinicians

Practice addresses (Care Compare)

600 John Deere Rd
Suite 200
Moline, IL 61265-6812
Phone (309) 779-4200

Hospital & facility affiliations

  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

Merit-based Incentive Payment System (MIPS)

Final score
62.74 of 100Reported as group
Quality
78.19
Promoting interoperability
0
Improvement activities
40
Cost
80.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision52
Removal of tissue1-10
Removal of skin lesions1180
Removal or shaving of skin growth24
Skin biopsy299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036160480ILMDDermatology Physician
MD176337ORMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Arts Associates, LTD. CurrentSince Aug 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Dermatology Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 19, 2016 Accepting new patients

Locations

600 John Deere Rd
Ste 200
Moline, IL 61265
Phone (309) 779-4200

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3600 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: uminiter868549@oc.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1073879128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656897",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JOHN DEERE RD STE 200",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656897",
            "telephone_number": "309-779-4200",
            "fax_number": "309-779-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINITER",
        "first_name": "UNA",
        "middle_name": "CLARE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD176337",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036160480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500659596",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "uminiter868549@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10151 SE Sunnyside Rd Ste 240",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.