Roland Takashi Minami, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

G21902 Issued in CA

Practice address

1240
South Eliseo Dr 102
Greenbrae, CA 94904

Phone

(415) 461-1240

NPI assigned

Mar 12, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760514137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240",
            "address_2": "SOUTH ELISEO DR 102",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "415-461-1240",
            "fax_number": "415-461-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240",
            "address_2": "SOUTH ELISEO DR 102",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "415-461-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINAMI",
        "first_name": "ROLAND",
        "middle_name": "TAKASHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G21902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bria Nicole Milicevic, M.A.
• Janet Patricia Miller-Melka, RNFA
• Jessie Miller
• Megan Amanda Miller, LMHC
• Shari Lynn Miller, PA
• Cynthia Mia Mitchel, N.P.,RNC
• Lloyd Tomoaki Miyawaki, MD
• Michael J. Molosky, D.D.S.
• Alta Monroe, RN
• Susan Montana, MFT

• Plastic Surgery Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.