Individual provider Active NPI

Matthew Cameron Minick, M.D.

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1811926959
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR0074361 Issued in CO
Practice address
2121 S Oneida St Ste 200
Denver, CO 80224-2551
Phone
(303) 757-6418
Fax
(303) 757-2209
NPI assigned
Jul 1, 2006
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR0074361 CO Primary

Addresses

Primary practice location

2121 S Oneida St Ste 200
Denver, CO 80224-2551

Mailing address

2121 S Oneida St Ste 200
Denver, CO 80224-2551
Phone (303) 757-6418

Other practice location 1

11960 Lioness Way Ste 200
Parker, CO 80134-5640
Phone (303) 471-5060

Other identifiers 2

IdentifierTypeStateIssuer
2699583-00MedicaidFL
46101OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR0074361COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Denver Pediatrics, PC Pediatrics CurrentSince Jan 31, 2021 Accepting new patients
Southeast Denver Pediatrics, PC Pediatrics CurrentSince Nov 7, 2025 Accepting new patients
Premier Care Pediatrics, PA Pediatrics Past Accepting new patients

Locations

2121 S Oneida St
Ste 200
Denver, CO 80224
Phone (303) 322-9313

11960 Lioness Way
Ste 200
Parker, CO 80134
Phone (303) 471-5060

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.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1811926959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S ONEIDA ST STE 200",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802242551",
            "telephone_number": "303-757-6418",
            "fax_number": "303-757-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S ONEIDA ST STE 200",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802242551",
            "telephone_number": "303-757-6418",
            "fax_number": "303-757-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11960 Lioness Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801345640",
            "country_code": "US",
            "telephone_number": "303-471-5060",
            "fax_number": "303-471-5062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINICK",
        "first_name": "MATTHEW",
        "middle_name": "CAMERON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR0074361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2699583-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.