Individual provider Active NPI

Renee Carole Minjarez, M.D.

  • Vascular Surgery Physician
  • Bellevue, WA
National Provider Identifier
1639373277
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD60158478 Issued in WA
Practice address
1135 116TH Ave NE
Suite 305
Bellevue, WA 98004-4623
Phone
(425) 453-1772
Fax
(425) 453-0603
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LL16254 OR
Vascular Surgery Physician 2086S0129X MD60158478 WA Primary

Addresses

Primary practice location

1135 116TH Ave NE
Suite 305
Bellevue, WA 98004-4623

Mailing address

1135 116TH Ave NE
Suite 305
Bellevue, WA 98004-4623
Phone (206) 592-5000

Other identifiers 1

IdentifierTypeStateIssuer
1639373277MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100903000046 WA Practitioner - Vascular Surgery 5597889170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians
Lake Washington Vascular PLLCGroup PAC ID 6103716782, 5 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

1135 116TH Ave NE
Suite 305
Bellevue, WA 98004-4623
Phone (425) 453-1772

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion20
Laminectomy or laminotomy (partial removal of spine bones)1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)25
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL16254ORMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Washington Vascular PLLC Vascular Surgery CurrentSince Jul 15, 2010 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Aug 31, 2025 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Aug 31, 2025 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

1135 116th Ave NE
Ste 305
Bellevue, WA 98004
Phone (425) 453-1772

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

12333 NE 130th Ln
Ste 425
Kirkland, WA 98034
Phone (425) 453-1772

Organizations & group practices 4

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 3

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1639373277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "SUITE 305",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "206-592-5000",
            "fax_number": "206-824-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "SUITE 305",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "425-453-1772",
            "fax_number": "425-453-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINJAREZ",
        "first_name": "RENEE",
        "middle_name": "CAROLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "LL16254",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60158478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639373277",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.