Organization Active NPI

Darin M Minkin Inc

Doing business as Darin M Minkin DO Inc

  • Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1255597738
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
200170421 Issued in MO
Legal business name
DARIN M MINKIN INC
Doing business as
Darin M Minkin DO Inc
Practice address
2355 Dougherty Ferry Rd
Ste 430
Saint Louis, MO 63122-3356
Phone
(314) 965-8410
NPI assigned
Aug 4, 2008
Last updated
Mar 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Authorized official

Name
Shannon Marti
Title
Manager
Phone
(888) 826-4546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 200170421 MO Primary

Addresses

Primary practice location

2355 Dougherty Ferry Rd
Ste 430
Saint Louis, MO 63122-3356

Mailing address

2355 Dougherty Ferry Rd
Ste 430
Saint Louis, MO 63122-3356
Phone (314) 965-8410

Other identifiers 1

IdentifierTypeStateIssuer
209057603MedicaidMO

Other names 1

  • Darin M Minkin DO Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080806000216 MO Part B Supplier - Clinic/Group Practice 7012081284 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Louis, MO; Creve Coeur, MO

National Provider Directory

National Provider Directory

Locations

2355 Dougherty Ferry Rd
Ste 430
Saint Louis, MO 63122
Phone (314) 821-5002

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1255597738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 DOUGHERTY FERRY RD",
            "address_2": "STE 430",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223356",
            "telephone_number": "314-965-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 DOUGHERTY FERRY RD",
            "address_2": "STE 430",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223356",
            "telephone_number": "314-965-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARIN M MINKIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "MARTI",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "888-826-4546"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "200170421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209057603",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Darin M Minkin DO Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.