Individual provider Active NPI

Paul Sander Mintz, MD

  • Anesthesiology Physician
  • Wyomissing, PA
National Provider Identifier
1265494389
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD030435E Issued in PA
Practice address
200 Reading Blvd
Wyomissing, PA 19610-2236
Phone
(610) 223-8287
Fax
(610) 374-9246
NPI assigned
Apr 4, 2006
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD030435E PA Primary

Addresses

Primary practice location

200 Reading Blvd
Wyomissing, PA 19610-2236

Mailing address

200 Reading Blvd
Wyomissing, PA 19610-2236
Phone (610) 223-8287

Other identifiers 1

IdentifierTypeStateIssuer
0010075800001MedicaidPA

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
I20101011000331 PA Practitioner - Anesthesiology 2860450301 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Professional Services CurrentSince Jul 1, 2017 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients

Locations

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 3

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1265494389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 READING BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102236",
            "telephone_number": "610-223-8287",
            "fax_number": "610-374-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 READING BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102236",
            "telephone_number": "610-223-8287",
            "fax_number": "610-374-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "PAUL",
        "middle_name": "SANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD030435E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010075800001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.