Tracy A. Minichiello, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A69780 Issued in CA

Practice address

400 Parnassus Ave
San Francisco, CA 94143-2202

Phone

(415) 502-1413

Fax

(415) 353-2467

NPI assigned

Apr 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1205893823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO STREET, SUITE 625, BOX 1821",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432202",
            "telephone_number": "415-502-1413",
            "fax_number": "415-353-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINICHIELLO",
        "first_name": "TRACY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A6978000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Angelina Minero, MSW
• Jacob Thomas Ming, D.D.S.
• Matthew Dominic Mingrone, MD
• Huma Minhas
• Douglas N. Miniati, M.D.
• Kathleen Minioza
• Altamara Tami Minix
• Minjae Kim DMD, Inc.
• Sade Guevara Minkey
• Elizaveta Minko

• Internal Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.