Individual provider Active NPI

Mitchell Minana, MD

  • Anesthesiology Physician
  • Spokane, WA
National Provider Identifier
1194730069
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
28954 Issued in WA
Practice address
104 West 5TH Ave
Suite 230E
Spokane, WA 99204-2483
Phone
(509) 838-8828
Fax
(509) 835-4058
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 28954 WA Primary

Addresses

Primary practice location

104 West 5TH Ave
Suite 230E
Spokane, WA 99204-2483

Mailing address

104 West 5TH Ave
Suite 230E
Spokane, WA 99204-2483
Phone (509) 838-8828

Other identifiers 1

IdentifierTypeStateIssuer
8129793MedicaidWA

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
I20101019000276 WA Practitioner - Anesthesiology 5092908434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
83.21
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28954WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Service- Washington Anesthesiology CurrentSince Apr 22, 2015 Accepting new patients
Physician Anesthesia Group PS Anesthesiology Past Accepting new patients

Locations

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1194730069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WEST 5TH AVE",
            "address_2": "SUITE 230E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042483",
            "telephone_number": "509-838-8828",
            "fax_number": "509-835-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WEST 5TH AVE",
            "address_2": "SUITE 230E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042483",
            "telephone_number": "509-838-8828",
            "fax_number": "509-835-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINANA",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "28954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8129793",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.