NPIMap

Individual provider Active NPI

Olga V Minkoff, MD

  • Family Medicine Physician
  • Cambridge, MA
National Provider Identifier
1467420190
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48059 Issued in WI
Practice address
725 Concord Ave
Ste 4100
Cambridge, MA 02138-1040
Phone
(617) 864-8822
Fax
(617) 491-9153
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 48059 WI Primary

Addresses

Primary practice location

725 Concord Ave
Ste 4100
Cambridge, MA 02138-1040

Mailing address

725 Concord Ave
Ste 4100
Cambridge, MA 02138-1041
Phone (617) 864-8822

Other identifiers 2

IdentifierTypeStateIssuer
ME96893OtherFLLICENSE
235872OtherMAMA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080807000149 MA Practitioner - Family Practice 5698795987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Mount Auburn Professional Services IncGroup PAC ID 6103725031, 229 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

725 Concord Ave
Suite 3600
Cambridge, MA 02138-1082
Phone (617) 354-3131

Hospital & facility affiliations

  • Pathways Healthcare Home health agency, Westwood, MA, CCN 227569
  • All Care Vna-Greater Lynn Inc Home health agency, Lynn, MA, CCN 227263
  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48059WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Auburn Professional Services Inc Family Medicine CurrentSince Jul 1, 2008 Accepting new patients
Martin Memorial Medical Center Inc Past Accepting new patients
Martin Memorial Physician Corporation Inc PastSince Apr 1, 2004 Accepting new patients
Mt Auburn Prof Services Past Accepting new patients

Locations

725 Concord Ave
Ste 3600
Cambridge, MA 02138
Phone (617) 354-3131

725 Concord Ave
Ste 6100
Cambridge, MA 02138
Phone (617) 864-8822

725 Concord Ave
Ste 4100
Cambridge, MA 02138
Phone (617) 864-8822

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

Interoperability endpoints

  • Direct secure messaging: ominkoff254254@direct.bilh.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1467420190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "address_2": "STE 4100",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381041",
            "telephone_number": "617-864-8822",
            "fax_number": "617-491-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "address_2": "STE 4100",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381040",
            "telephone_number": "617-864-8822",
            "fax_number": "617-491-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKOFF",
        "first_name": "OLGA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "48059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME96893",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA LICENSE",
            "identifier": "235872",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.