Daniel Mark Minter, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA178695 Issued in OR

Practice address

2115 NE Wyatt CT Ste 201
Bend, OR 97701-7680

Phone

(541) 585-2400

NPI assigned

Oct 22, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northwest Medical Specialist LLC

  dba NW Brain and Spine

  • Neurological Surgery Physician
  • Bend, OR
  • NPI 1588674279
  Medicare reassignment

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1750634218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 NE WYATT CT STE 201",
            "address_2": "SUITE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017680",
            "telephone_number": "541-585-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 NE WYATT CT STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017680",
            "telephone_number": "541-585-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTER",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-22",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA178695",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Health Consulting LLC
• Angelina Mingus, RN
• Kelley Ray Mingus, D.M.D
• Sharyn Elaine Minnick
• Daniela Minnis, OD
• Angela Marie Mion, OTR/L
• Maryam Mirahmadi
• Marjon Mirbaha, L.AC.
• Mirror Pond Counseling LLC
• Mirror Pond Dental, LLC

• Physician Assistant in Bend, OR
• Providers in Bend, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.