Bohdan M Minczak, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD064462L Issued in PA

Practice address

245 N 15TH Street
NCB Room 2108
Philadelphia, PA 19102

Phone

(215) 762-2361

Fax

(215) 762-1307

NPI assigned

Aug 24, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1245335611
  NPD
• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  NPD
• Jefferson Acute Care Physicians, PC

  • Urgent Care Clinic/Center
  • Flourtown, PA
  • NPI 1245892314
  NPD
• Jefferson Acute Care Physicians, PC

  • Urgent Care Clinic/Center
  • Bensalem, PA
  • NPI 1689136145
  NPD
• Jefferson Acute Care Physicians, PC

  dba Jefferson Urgent Care

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1730571324
  NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1396738456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021320",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N 15TH STREET",
            "address_2": "NCB ROOM 2108",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-2361",
            "fax_number": "215-762-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINCZAK",
        "first_name": "BOHDAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD064462L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8523801",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017079530005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael S Mina, R.PH.
• Kenji Minakata, MD
• Brian Andrew Minarcik, D.O
• Minard Duka DMD PC (Alb Dental)
• Alexis Brooke Mincer, PA-C
• Mind Belly Soul Nutrition LLC
• Mind Body Nourish LLC
• Mind Power Counseling LLC
• Jodi Mindell, PH.D.
• Mindful Essence Therapeutic Services, LLC

• Emergency Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.