Individual provider Active NPI

John E. Minor, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Utica, NY
National Provider Identifier
1629228010
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
176034 Issued in NY
Practice address
1508 Genesee St
Utica, NY 13502-5178
Phone
(315) 798-8737
Fax
(315) 732-1702
NPI assigned
Sep 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 34.008368 OH
Physical Medicine & Rehabilitation Physician 208100000X 0102202192 VA
Physical Medicine & Rehabilitation Physician 208100000X 25MB05670800 NJ
Physical Medicine & Rehabilitation Physician 208100000X 176034 NY Primary

Addresses

Primary practice location

1508 Genesee St
Utica, NY 13502-5178

Mailing address

1508 Genesee St
Utica, NY 13502-5178
Phone (315) 798-8737

Other identifiers 1

IdentifierTypeStateIssuer
03207738MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050314000788 OH Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 1759351588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Pennsylvania State University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dublin Pain Clinic LLCGroup PAC ID 0143310318, 2 clinicians

Practice addresses (Care Compare)

440 Industrial Mile Rd
Columbus, OH 43228-2411
Phone (614) 851-1400

Hospital & facility affiliations

  • Doctors Hospital Hospital, Columbus, OH, CCN 360152
  • Grant Medical Center Hospital, Columbus, OH, CCN 360017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MB05670800NJMDPhysical Medicine & Rehabilitation Physician
34.008368OHMDPhysical Medicine & Rehabilitation Physician
0102202192VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dublin Pain Clinic LLC CurrentSince Jun 24, 2018 Accepting new patients

Locations

440 Industrial Mile Rd
Columbus, OH 43228
Phone (614) 851-1400

Organizations & group practices 1

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 2

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1629228010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025178",
            "telephone_number": "315-798-8737",
            "fax_number": "315-732-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025178",
            "telephone_number": "315-798-8737",
            "fax_number": "315-732-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "34.008368",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0102202192",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB05670800",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "176034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03207738",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.