Sandra Lynn Minta, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2065 Issued in OR

Practice address

5234 SW Philomath Blvd
Corvallis, OR 97333-1042

Phone

(541) 768-4970

NPI assigned

Apr 16, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sminta129871@samhealth.direct-ci.com

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.

• County of Linn

  • Community/Behavioral Health Agency
  • Albany, OR
  • NPI 1760575781
  Medicare reassignment
• County of Linn

  • Community/Behavioral Health Agency
  • Albany, OR
  • NPI 1194814103
  NPD

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1427273341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5234 SW PHILOMATH BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331042",
            "telephone_number": "541-768-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTA",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sminta129871@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "5234 SW Philomath Blvd",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973331042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kijrstin Minarsich
• Piper Mincy
• Kyle Mindick, DO
• Josh Michael Miner, PT, DPT
• Melisa Miner
• Tiffani Roshawn Minter
• Justin Tyler Miracle
• Gracenanci Rachel Miranda-Leon
• Kimberlyn M Misamore
• Abraham James Mitchell, BS

• Psychologist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.