Active NPI
Minami Watanabe, MD, MPH
- Surgery Physician
- Allentown, PA
National Provider Identifier
1225706534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MT223568
- Practice address
- 1250 S Cedar Crest Blvd
Allentown, PA 18103 - Phone
- (610) 402-8000
- NPI assigned
- Sep 1, 2021
- Reactivated
- Nov 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MT223568 | PA | Primary |
Addresses
Primary practice location
1250 S Cedar Crest Blvd
Allentown, PA 18103
Mailing address
1247 S Cedar Crest Blvd.
Allentown, PA 18103
Phone (610) 402-2570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT223568 | PA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700611200000",
"number": "1225706534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1247 S CEDAR CREST BLVD.",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18103",
"telephone_number": "610-402-2570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 S CEDAR CREST BLVD",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18103",
"telephone_number": "610-402-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATANABE",
"first_name": "MINAMI",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-01",
"last_updated": "2023-11-22",
"certification_date": "2022-12-19",
"deactivation_date": "2022-12-19",
"reactivation_date": "2023-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MT223568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.