Active NPI
Jeffrey Lee Minikel, MD
- Orthopaedic Surgery Physician
- Shawano, WI
National Provider Identifier
1114907011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 21786
- Practice address
- 100 County Road B
Shawano, WI 54166-7072 - Phone
- (920) 831-5050
- Fax
- (920) 738-6400
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 21786 | WI | Primary |
Addresses
Primary practice location
100 County Road B
Shawano, WI 54166-7072
Mailing address
PO Box 8003
Appleton, WI 54912-8003
Phone (920) 996-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30478900 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21786 | WI | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milwaukee Clinic of Ortho Surgery LTD | Orthopaedic Surgery | Past | Accepting new patients |
| Milwaukee Clinic of Ortho Surgery, LTD. | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
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- Orthopaedic Surgery Physician
- Brookfield, WI
- NPI 1215169073
-
- Orthopaedic Surgery Physician
- Franklin, WI
- NPI 1295788743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331769600000",
"number": "1114907011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8003",
"city": "APPLETON",
"state": "WI",
"postal_code": "549128003",
"telephone_number": "920-996-3200",
"fax_number": "920-738-5787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COUNTY ROAD B",
"city": "SHAWANO",
"state": "WI",
"postal_code": "541667072",
"telephone_number": "920-831-5050",
"fax_number": "920-738-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINIKEL",
"first_name": "JEFFREY",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2012-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WI",
"license": "21786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30478900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shawano, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.