Individual provider Active NPI

Elliot Thomas Min, MD

  • Neurological Surgery Physician
  • Walnut Creek, CA
National Provider Identifier
1134510589
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD61279013 Issued in WA
Practice address
120 La Casa Via Ste 102
Walnut Creek, CA 94598-3092
Phone
(925) 867-1900
Fax
(925) 867-1901
NPI assigned
Feb 6, 2015
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A142420 CA
Neurological Surgery Physician 207T00000X MD61279013 WA Primary
Neurological Surgery Physician 207T00000X ME150080 FL

Addresses

Primary practice location

120 La Casa Via Ste 102
Walnut Creek, CA 94598-3092

Mailing address

120 La Casa Via Ste 102
Walnut Creek, CA 94598-3092
Phone (925) 867-1900

Other identifiers 1

IdentifierTypeStateIssuer
2213823MedicaidWA

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
I20220825003173 WA Practitioner - Neurosurgery 9830478320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Vanderbilt University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 500
Bellevue, WA 98004-4627
Phone (425) 635-6560

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1000

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion123
Laminectomy or laminotomy (partial removal of spine bones)60

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142420CAMDNeurological Surgery Physician
ME150080FLMDNeurological Surgery Physician
MD61279013WAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Jun 1, 2023 Accepting new patients
King County Public Hospital District No 2 CurrentSince Jun 1, 2023 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Aug 14, 2023 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Aug 14, 2023 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Overlake Medical Center & Clinics Past Accepting new patients

Locations

1135 116th Ave NE
Ste 500
Bellevue, WA 98004
Phone (425) 454-3938

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: emin753512@fhsce.catholichealth.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1134510589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LA CASA VIA STE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983092",
            "telephone_number": "925-867-1900",
            "fax_number": "925-867-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LA CASA VIA STE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983092",
            "telephone_number": "925-867-1900",
            "fax_number": "925-867-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "ELLIOT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A142420",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD61279013",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME150080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2213823",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.