Ira R. Mintz, MO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G29085 Issued in CA

Practice address

1516 Cotner Ave
Los Angeles, CA 90025-3303

Phone

(310) 445-2800

Fax

(310) 479-1459

NPI assigned

Aug 3, 2006

Last updated

Jan 31, 2014By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kern Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1720023997
  NPD (past)
• Vacaville Imaging Center Medical

  • Diagnostic Radiology Physician
  • Vacaville, CA
  • NPI 1972557569
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1669480927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240086",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900249186",
            "telephone_number": "310-445-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 COTNER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253303",
            "telephone_number": "310-445-2800",
            "fax_number": "310-479-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "IRA",
        "middle_name": "R.",
        "credential": "MO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G29085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G290850",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G290850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Victoria Minota Pacheco, MD
• Mint Med PC
• Michael Louis Minter
• Sara E Minter
• Sodah Minty
• Kira Rachel Mintz
• Leah E Mintz, M.D.
• Marla Ellen Mintz, R.E. ELECTROLOGIST
• Steve Mintz
• Karen Ann Miotto

• Diagnostic Radiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.