Evan E Mintz, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110003897 Issued in VA

Practice address

808 Eden Way N Ste 102
Chesapeake, VA 23320-0745

Phone

(757) 216-4030

Fax

(757) 216-4029

NPI assigned

Jul 17, 2012

Sex

Female

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

Enrolled in VA

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

Interoperability endpoints

• Direct secure messaging: evan.mintz.1@2912.direct.athenahealth.com

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.

• Winke Orthopedic Pain Management Center

  • Physical Medicine & Rehabilitation Physician
  • Chesapeake, VA
  • NPI 1386973253
  Medicare reassignment

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1790030666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 EDEN WAY N STE 102",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200745",
            "telephone_number": "757-216-4030",
            "fax_number": "757-216-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 EDEN WAY N STE 102",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200745",
            "telephone_number": "757-216-4030",
            "fax_number": "757-216-4029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "154 Burnetts Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348366",
            "country_code": "US",
            "telephone_number": "757-216-4030",
            "fax_number": "757-216-4029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "EVAN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindwell
• Mindwell
• Sarah Mines
• Sharon Hooper Minor
• Linda Sue Mintle, PHD
• Miraculous Hands Home Healthcare
• Chelsea Rae Miranda, LMHP-R
• Ashley Loretta Mirmak, CNM
• Mitra Mirmotahari
• Glenda Bondal Mitchell, D.C.

• Medical Physician Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.