NPIMap

Individual provider Active NPI

Laura Michele Minik, PA-C

  • Physician Assistant
  • Beavercreek, OH
National Provider Identifier
1720742968
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007120RX Issued in OH
Practice address
75 Sylvania Dr
Beavercreek, OH 45440-3237
Phone
(937) 320-5050
Fax
(937) 320-5060
NPI assigned
Oct 25, 2021
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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 50.007120RX OH Primary

Addresses

Primary practice location

75 Sylvania Dr
Beavercreek, OH 45440-3237

Mailing address

One Gi Credentialing Department
PO Box 381468
Germantown, TN 38183-4258

Other practice location 1

415 Byers Rd Ste 100
Miamisburg, OH 45342-3684
Phone (937) 320-5050

Other practice location 2

4200 Indian Ripple Rd
Dayton, OH 45440-3248
Phone (937) 320-5050

Other practice location 3

9000 N Main St
Englewood, OH 45415-1180
Phone (937) 208-3876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209002896 OH Practitioner - Physician Assistant 4082004866 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Gastroenterology, LLCGroup PAC ID 9537064407, 74 clinicians

Practice addresses (Care Compare)

4200 Indian Ripple Rd
Beavercreek, OH 45440-3248

75 Sylvania Dr
Beavercreek, OH 45440-3237

9000 N Main St
Suite 405
Englewood, OH 45415-1170
Phone (937) 320-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1720742968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GI CREDENTIALING DEPARTMENT",
            "address_2": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381834258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SYLVANIA DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403237",
            "telephone_number": "937-320-5050",
            "fax_number": "937-320-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Byers Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453423684",
            "country_code": "US",
            "telephone_number": "937-320-5050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4200 Indian Ripple Rd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454403248",
            "country_code": "US",
            "telephone_number": "937-320-5050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 N Main St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151180",
            "country_code": "US",
            "telephone_number": "937-208-3876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINIK",
        "first_name": "LAURA",
        "middle_name": "MICHELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007120RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.