NPIMap

Individual provider Active NPI

Charles Mininger

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1508146309
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA101819 Issued in MA
Practice address
1 Boston Medical Ctr PL FL Place1
Boston, MA 02118-2908
Phone
(847) 570-2000
NPI assigned
Aug 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA101819 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL FL Place1
Boston, MA 02118-2908

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690
Phone (617) 414-5405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111208000042 IL Practitioner - Physician Assistant 9931374691 Reassigns benefits to 4 organizations
I20260508000052 MA Practitioner - Physician Assistant 9931374691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Emergency Physician Foundation IncGroup PAC ID 4981596095, 74 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-5481

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA101819MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Jan 20, 2015 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 6, 2018 Accepting new patients
Cook County CurrentSince Jan 20, 2015 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Nov 2, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 16, 2013 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 6, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 16, 2013 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Dept 5777
Carol Stream, IL 60122

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

8131 S May St
Chicago, IL 60620
Phone (312) 365-5801

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

55 W Cermak Rd
Chicago, IL 60616
Phone (312) 326-4472

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

Organizations & group practices 11

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 8

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1508146309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL FL PLACE1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "847-570-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MININGER",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.