Individual provider Active NPI

Thomas J Minter, MD

  • Emergency Medicine Physician
  • Tacoma, WA
National Provider Identifier
1114973674
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00028652 Issued in WA
Practice address
1717 S J St
Tacoma, WA 98405-4933
Phone
(253) 426-4101
Fax
(253) 838-6418
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00028652 WA Primary

Addresses

Primary practice location

1717 S J St
Tacoma, WA 98405-4933

Mailing address

505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180

Other identifiers 3

IdentifierTypeStateIssuer
0171249OtherWALIWA ST JOE MEDICAL
8134678MedicaidWA
MI9061OtherWABSWA ST JOE MEDICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000427 WA Practitioner - Emergency Medicine 6002972122 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Mar 17, 2009 Accepting new patients
Northwest Physician Associates, Apc Emergency Medicine Past Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1114973674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-4101",
            "fax_number": "253-838-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTER",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00028652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA ST JOE MEDICAL",
            "identifier": "0171249",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8134678",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA ST JOE MEDICAL",
            "identifier": "MI9061",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.