Wanda Renee Minnis-Dyson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD19253 Issued in DC

Practice address

650 Pennsylvania Ave SE
Suite 250
Washington, DC 20003-4318

Phone

(202) 575-4660

Fax

(202) 547-7900

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

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.

• Universal Support Agency LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Washington, DC
  • NPI 1588353767
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 23, 2013 through Dec 23, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 11, 2016.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1093837460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PENNSYLVANIA AVE SE",
            "address_2": "SUITE 250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034318",
            "telephone_number": "202-575-4660",
            "fax_number": "202-547-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PENNSYLVANIA AVE SE",
            "address_2": "SUITE 250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034318",
            "telephone_number": "202-575-4660",
            "fax_number": "202-547-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIS-DYSON",
        "first_name": "WANDA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "DC",
            "license": "MD19253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0491820",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Flore Marcelle Minka
• Benjamin Minkins
• Serkalem Meseret Minlargilh
• Ruben Minlend
• Theresa M Minni, LICSW
• Caterina P Minniti, MD
• Alicia A Minor
• Beatrice Minor
• Darilyn Niya Minor, PHARMD
• David Maurice Minor Jr.

• All providers in Washington, DC
• Specialist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.