Individual provider Active NPI

Robert Dan Mino, MD

  • Urology Physician
  • Horsham, PA
National Provider Identifier
1265489983
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD038144E Issued in PA
Practice address
3 Village Rd
Suite 100
Horsham, PA 19044-3812
Phone
(215) 884-7114
Fax
(215) 884-7147
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD038144E PA Primary

Addresses

Primary practice location

3 Village Rd
Suite 100
Horsham, PA 19044-3812

Mailing address

PO Box 1287
Blue Bell, PA 19422-0410
Phone (484) 530-0205

Other identifiers 1

IdentifierTypeStateIssuer
0011791810001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080415000253 PA Practitioner - Urology 3476583840 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD038144EPAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Health Surgery Center, LLC CurrentSince Jan 1, 2016 Accepting new patients
Alliance Physician Services, PC Urology CurrentSince Apr 20, 2017 Accepting new patients
Alliance Physician Services, PC Urology Current Accepting new patients
Urology Health Surgery Center, LLC CurrentSince Jan 1, 2016 Accepting new patients
Alliance Physician Services, PC / Dba Midlantic Urology Urology CurrentSince Apr 20, 2017 Accepting new patients
Alliance Physician Services, PC Urology Past Accepting new patients

Locations

1235 Old York Rd
Ste 218
Abington, PA 19001
Phone (215) 517-1100

1235 Old York Rd
Ste 210
Abington, PA 19001
Phone (215) 517-1100

599 W State St
Ste 303
Doylestown, PA 18901
Phone (215) 230-9070

3 Village Rd
Ste 100
Horsham, PA 19044
Phone (215) 830-8870

1800 Byberry Rd
Ste 1204
Huntingdon Vy, PA 19006
Phone (215) 517-1100

211 S Gulph Rd
Ste 200
Kng of Prussa, PA 19406
Phone (610) 382-5910

3941 Commerce Ave
Willow Grove, PA 19090
Phone (215) 481-4000

Organizations & group practices 6

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1265489983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1287",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194220410",
            "telephone_number": "484-530-0205",
            "fax_number": "484-530-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VILLAGE RD",
            "address_2": "SUITE 100",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190443812",
            "telephone_number": "215-884-7114",
            "fax_number": "215-884-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINO",
        "first_name": "ROBERT",
        "middle_name": "DAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD038144E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011791810001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.