Renee Lynn Minasov, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

344812 Issued in NY

Practice address

6 Hampden PL
Utica, NY 13502-5631

Phone

(315) 624-3666

Fax

(315) 733-2846

NPI assigned

Jan 21, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1516492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1396253605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE STREET",
            "address_2": "BUSINESS OFFICE ROOM 315",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-801-3282",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HAMPDEN PL",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025631",
            "telephone_number": "315-624-3666",
            "fax_number": "315-733-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINASOV",
        "first_name": "RENEE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-21",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05726930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Ja Miller, LCSW/CASAC
• Regina Miller
• James H Mills, R.N.
• James Millson, RN
• Lemuel Mims
• John E. Minor, D.O.
• Chaille Mintah
• Sean Vincent Miri, CASAC
• Upama Mishra, MD
• Walter E Misiaszek, LCSW

• Family Nurse Practitioner in Utica, NY
• Providers in Utica, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.