Jacqueline Minasso, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

286880 Issued in NY

Practice address

1991 Marcus Ave Suite 300
New Hyde Park, NY 11042-2123

Phone

(516) 719-3376

Fax

(516) 321-8514

NPI assigned

Mar 31, 2012

Last updated

Dec 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

State University of Ny Upstate Medical University, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jminasso48021@direct.kelsey-seybold.com

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.

• Kelsey-Seybold Medical Group, PLLC

  dba Kelsey Seybold Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Dermatology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1407122674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE SUITE 300",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422123",
            "telephone_number": "516-719-3376",
            "fax_number": "516-321-8514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Saint Paul Pl",
            "address_2": "MERCY MEDICAL CENTER, DEPARTMENT OF MEDICINE, 7TH FLOOR",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212022123",
            "country_code": "US",
            "telephone_number": "410-332-9694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8233 N Sam Houston Pkwy E",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773962922",
            "country_code": "US",
            "telephone_number": "713-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 Saint Paul Pl",
            "address_2": "MERCY MEDICAL CENTER, DEPARTMENT OF MEDICINE, 7TH FLOOR",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212022123",
            "country_code": "US",
            "telephone_number": "410-332-9694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINASSO",
        "first_name": "JACQUELINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-31",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "T9451",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "286880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salman Afzal Millwala, MD
• Bernard Milman, M.D.
• Christine M Milner, PNP
• Fabiola Milord, D.D.S.
• Arnold Min
• Mindbuilderz LLC
• Miri Mineh, PHARM.D
• Felicia Cindy Minerva, LCSW-R
• Amna Minhas
• Fariha Mirza, RPH

• Dermatology Physician in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.