Mitchell Minix, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004109A Issued in IN

Practice address

6110 Maplecrest Rd
Fort Wayne, IN 46835-2524

Phone

(260) 486-8833

NPI assigned

Jun 27, 2018

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 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martin R White OD IncGroup PAC ID 4082745138, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Martin R White OD Inc

  • Optometrist
  • Fort Wayne, IN
  • NPI 1134440183
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1760977193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468352524",
            "telephone_number": "260-486-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468352524",
            "telephone_number": "260-486-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINIX",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004109A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "18004109A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Reig Miner, PMHNP
• Robert W Miner, M.D.
• Sarah E. Miner, AUD
• Laura Anne Minich, MS, CCC-SLP
• Natosha E. Minick, NP
• Tyler Minnich
• Erielle Minor, RBT
• Rebecca E Minser, M.D.
• Cynthia Sue Mintch, W.H.N.P.
• Mahshid Mir

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.