Matthew Mino, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

63901 Issued in AZ

Practice address

2801 E Camelback Rd Ste 100
Phoenix, AZ 85016-4363

Phone

(480) 576-4310

Fax

(480) 576-4311

NPI assigned

Sep 25, 2009

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 15, 2022 through Mar 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southwest Breast and Aesthetics, LLC

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1386237394

  Single Specialty

  NPD
• Joseph Zakhary MD LLC

  • Plastic Surgery Physician
  • Phoenix, AZ
  • NPI 1942700984

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1265766125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E CAMELBACK RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164363",
            "telephone_number": "480-576-4310",
            "fax_number": "480-576-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E CAMELBACK RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164363",
            "telephone_number": "480-576-4310",
            "fax_number": "480-576-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 S Price Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852483573",
            "country_code": "US",
            "telephone_number": "480-576-4300",
            "fax_number": "480-576-4311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINO",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-25",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "63901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "S1660",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL LICENSE",
            "identifier": "63901",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minimally Invasive Surgical Consultants PLC
• Devin Nathaniel Minior, MD
• Ministry on the Move Inc (Wolfe-Colbert & Associates)
• Andrew Minkley
• Erika Minnix
• David D Minor, DO
• Jansen Minor, COTA/L
• Katherine Anne Minor, P.A.-C.
• Michelle Minta, CRNA
• Minted Dental

• Plastic Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.