Individual provider Active NPI

Dennis Min, D.O.

  • Gastroenterology Physician
  • Middletown, OH
National Provider Identifier
1104808518
Registry record updated Apr 25, 2014
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Nov 20, 2022.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
207RG0100X Issued in OH
Practice address
1537 South Breiel Boulevard
Middletown, OH 45044-6703
Phone
(513) 425-8300
Fax
(513) 425-8301
NPI assigned
Nov 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 207RG0100X OH Primary

Addresses

Primary practice location

1537 South Breiel Boulevard
Middletown, OH 45044-6703

Mailing address

1537 South Breiel Boulevard
Middletown, OH 45044-6703
Phone (513) 425-8300

Other identifiers 3

IdentifierTypeStateIssuer
043814799OtherOHTAX ID#
2460877MedicaidOH
000000369974OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207RG0100XOHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Medical Center Past Accepting new patients
Gcga Physicians Inc. Gastroenterology PastSince Jun 5, 2019 Accepting new patients
Wilmington Physicians Group LLC PastSince Feb 1, 2018 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6237/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1104808518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 SOUTH BREIEL BOULEVARD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446703",
            "telephone_number": "513-425-8300",
            "fax_number": "513-425-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 SOUTH BREIEL BOULEVARD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446703",
            "telephone_number": "513-425-8300",
            "fax_number": "513-425-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-20",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "207RG0100X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "043814799",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2460877",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000369974",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.