Michael Minick, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00022728 Issued in WA

Practice address

1221 Highland Ave
Clarkston, WA 99403-2829

Phone

(509) 758-5511

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Internal Medicine

Education

Indiana University School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of IdahoGroup PAC ID 4688705346, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
• Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sound Physicians of Idaho

  • Hospitalist Physician
  • Lewiston, ID
  • NPI 1730407461

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Laennec Inpatient Services

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1053344085
  NPD (past)
• St. Joseph Hospital LLC

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Care Compare affiliation
• Tri-State Memorial Hospital

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693

  Hospital

  Care Compare affiliation
• St Joseph Hospital LLC

  • Oxygen Equipment & Supplies (DME)
  • Lewiston, ID
  • NPI 1992231799

  Hospital

  Care Compare affiliation
• St. Joseph Hospital LLC

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare affiliation

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1164536728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 7TH ST.",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 HIGHLAND AVE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032829",
            "telephone_number": "509-758-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINICK",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M4849",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00022728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kaye Merrill, RPH
• Elizabeth N Messinger, AM
• Meyers-Folsom Dental Clinic
• Robert M Meyers Sr., D.D.S.
• Zachary Robert Meyers, DDS
• Karen M Monroe, OTR/L
• Enrique C Montana, M.D.
• Rachel Montgomery
• Kayleigh Moyle
• Joseph Farayi Moyosviyi

• Internal Medicine Physician in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.