Michael Anthony Minadeo, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

G7852 Issued in TX

Practice address

2007 N Jefferson Ave
Mount Pleasant, TX 75455-2336

Phone

(817) 784-0222

Fax

(903) 572-0213

NPI assigned

Nov 15, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Staten Island Physician Practice PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568413169
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1356323489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103941",
            "telephone_number": "720-524-1001",
            "fax_number": "720-524-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 N JEFFERSON AVE",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754552336",
            "telephone_number": "817-784-0222",
            "fax_number": "903-572-0213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 N Gun Barrel Ln",
            "address_purpose": "LOCATION",
            "city": "Gun Barrel City",
            "state": "TX",
            "postal_code": "751563732",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "903-887-4822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 E Interstate 20",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760181119",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "817-417-0981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5494 Glen Lakes Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752314308",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "214-696-1579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3645 Dallas Pkwy",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938181",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "214-440-5201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 E Southlake Blvd",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760926501",
            "country_code": "US",
            "telephone_number": "817-784-0222",
            "fax_number": "817-467-5819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINADEO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G7852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PO87X1006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medical Doctor Assoc, Inc.
• Medical Plaza Cardiology
• Oghenetega Mirella Meir, PMHNP-BC
• Paul O Meriwether, M.D.
• Minadeo Eye Center PLLC
• Samuel Minefee, PTA
• Sherry Lynn Missildine, RN, MSN, ACNP-BC
• Caleb Heath Mitchell
• Jacqueline Mojica, APRN, PMHNP-BC
• Derek Walter Molina, FNP-C

• Specialist in Mount Pleasant, TX
• Providers in Mount Pleasant, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.