Charles K Minn, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD60566032 Issued in WA

Practice address

1708 Yakima Ave
Ste 107
Tacoma, WA 98405-5307

Phone

(253) 272-5881

Fax

(253) 383-0161

NPI assigned

Oct 25, 2012

Last updated

Oct 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, AK, OR, MT4 enrollments

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 4

Specialty

Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Medical Specialty GroupGroup PAC ID 2365838364, 56 clinicians

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Platinum Peaks Healthcare PCGroup PAC ID 0648784157, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park Rose Care Center Nursing home, Tacoma, WA, CCN 505239

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cminn4113462@ghc.direct-ci.net

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.

• Pacific Medical Dialysis Services

  • Nephrology Physician
  • Tacoma, WA
  • NPI 1285406249
  Medicare reassignment NPD Authorized official
• Pacific Medical Specialty Group

  • Internal Medicine Physician
  • Elma, WA
  • NPI 1548911811

  AK, MT, OR

  Medicare reassignment Care Compare group NPD
• Platinum Peaks Healthcare PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Tacoma, WA
  • NPI 1821982893

  AK

  Medicare reassignment Care Compare group NPD
• Christian Family Care Inc

  • Primary Care Clinic/Center
  • Federal Way, WA
  • NPI 1528196052

  Internal Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Care Center Anchorage Inc.

  dba Prestige Care and Rehabilitation Center of Anchorage

  • Skilled Nursing Facility
  • Anchorage, AK
  • NPI 1801021290
  NPD (past)
• Centennial SNF Healthcare LLC

  dba Centennial Post Acute

  • Skilled Nursing Facility
  • Anchorage, AK
  • NPI 1508615683
  NPD (past)
• Providence Health & Services Washington

  dba Providence Transitional Care Center

  • Skilled Nursing Facility
  • Anchorage, AK
  • NPI 1124025507
  NPD (past)

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

• BD Tacoma I, LLC

  dba Park Rose Care Center

  • Skilled Nursing Facility
  • Tacoma, WA
  • NPI 1316045537

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1508119736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "STE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-272-5881",
            "fax_number": "253-383-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE",
            "address_2": "STE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-272-5881",
            "fax_number": "253-383-0161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 15th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125209",
            "country_code": "US",
            "telephone_number": "206-375-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINN",
        "first_name": "CHARLES",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P7514",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P7514",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60566032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "349638",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "125 15th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mindset Tacoma LLC
• David M Minehan, MD
• Michael Mines, M.D.
• Gurpreet Kaur Minhas, ARNP
• Nancy Wairimu Minjire, ARNP
• Mino Ode' Counseling PLLC
• Sarah Minor, PY
• Melody Wanda Minott, LPN
• Jamie Rosario Minshull, LICSW
• Minsun James Song, DDS, PLLC.

• Nephrology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Nephrology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.