Individual provider Active NPI

John P Minadeo, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Saint Albans, VT
National Provider Identifier
1235160466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
0420009709 Issued in VT
Practice address
133 Fairfield St
Saint Albans, VT 05478-1726
Phone
(802) 524-5911
Fax
(802) 524-1057
NPI assigned
Jul 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 0420009709 VT Primary

Addresses

Primary practice location

133 Fairfield St
Saint Albans, VT 05478-1726

Mailing address

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-5911

Other identifiers 1

IdentifierTypeStateIssuer
OVN1915MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420009709VTMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Dec 1, 1998 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center Inc CurrentSince Apr 9, 2018 Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Dec 1, 1998 Accepting new patients

Locations

927 Ethan Allen Hwy
Unit 2
Milton, VT 05468
Phone (802) 524-8911

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

133 Fairfield St
Ste 102
Saint Albans, VT 05478
Phone (802) 524-5911

260 Crest Rd
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1223

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235160466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "802-524-5911",
            "fax_number": "802-524-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "802-524-5911",
            "fax_number": "802-524-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINADEO",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "VT",
            "license": "0420009709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1915",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.