Thomas A Minor, PA-C
Individual provider Active NPI Physician Assistant · Kalkaska, MI
NPI 1508937731 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508937731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601002040 (MI)
- Practice address
- 419 S Coral St
Kalkaska, MI 49646-2500 - Phone
- (231) 258-7506
- Fax
- (231) 258-7592
- NPI assigned
- Nov 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kalkaska Memorial Health Center
Practice addresses (Care Compare)
419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500
Hospital & facility affiliations
- Munson Home Care
- Kalkaska Memorial Health Center
- Munson Healthcare Cadillac Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110419000500 | MI | Practitioner - Physician Assistant | 6709061617 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601002040 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalkaska Memorial Health Center | Physician Assistant | Current | Accepting new patients |
| Kalkaska Memorial Health Center | Current |
Accepting new patients | |
| Kalkaska Memorial Health Center | Current |
Accepting new patients | |
| Kalkaska Memorial Health Center | Physician Assistant | Past | Accepting new patients |
Locations
419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500
Interoperability endpoints
- tminor@direct.mhc.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002040 | MI | Yes |
Addresses
Primary practice location
419 S Coral St
Kalkaska, MI 49646-2500
Mailing address
419 S Coral St
Kalkaska, MI 49646-2500
Phone (231) 258-7506
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TM002040 | Other | MI | BLUE CROSS |
Other providers in Kalkaska, MI
- Whitney Ashton Mervau
- Aneta Michalczuk
- Kimberly Anne Michels
- Patricia Michutka
- James Grawn Milliken
- Tamara K Molby
- Robert E Molter Jr.
- Mason C Moody
- Christopher Michael Morgan
- Stephanie Marie Murden
All providers in Kalkaska, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.