Mary Kate Mineman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085006767 Issued in IL

Practice address

18425 West Creek Dr
Stef
Tinley Park, IL 60477-2220

Phone

(708) 209-6783

NPI assigned

Oct 17, 2018

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates LTDGroup PAC ID 8628027273, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.27 of 100Reported as group

Quality

97.09

Improvement activities

40

Cost

81.45

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ACEFAA
• Direct secure messaging: mmineman@directaddress.net

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.

• Dermatology Associates LTD

  • Specialist
  • Tinley Park, IL
  • NPI 1497968945
  Medicare reassignment Care Compare group
• Dermatology Associates LTD

  • Non-Pharmacy Dispensing Site
  • Palos Heights, IL
  • NPI 1386255123
  NPD (past)

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1164998167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18425 WEST CREEK DR",
            "address_2": "STEF",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772220",
            "telephone_number": "708-209-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 WEST CREEK DR",
            "address_2": "STEF",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772220",
            "telephone_number": "708-209-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINEMAN",
        "first_name": "MARY",
        "middle_name": "KATE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "mmineman293383@direct.myadvocateaurora.org",
            "affiliation": "N",
            "endpointDescription": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18425 West Creek Dr",
            "address_2": "SteF",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604772220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.