Individual provider Active NPI

Stephen E Minor, M.D.

  • Interventional Cardiology Physician
  • Daytona Beach, FL
National Provider Identifier
1851309629
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME103969 Issued in FL
Practice address
350 N Clyde Morris Blvd
Suite 1
Daytona Beach, FL 32114-2733
Phone
(386) 238-3289
Fax
(386) 238-3296
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 239076 NY
Interventional Cardiology Physician 207RI0011X ME103969 FL Primary
Internal Medicine Physician 207R00000X ME103969 FL
Cardiovascular Disease Physician 207RC0000X ME103969 FL

Addresses

Primary practice location

350 N Clyde Morris Blvd
Suite 1
Daytona Beach, FL 32114-2733

Mailing address

PO Box 9671
Daytona Beach, FL 32120-9671
Phone (386) 676-7130

Other identifiers 4

IdentifierTypeStateIssuer
P00913614OtherFLRAILROAD MEDICARE
1851309629OtherFLTRICARE
001218000MedicaidFL
145H9OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090724000530 FL Practitioner - Cardiovascular Disease (Cardiology) 5799880191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

1041 Dunlawon Ave
Port Orange, FL 32127-7968
Phone (386) 322-4700

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709

311 N Clyde Morris Blvd
Suite 500C
Daytona Beach, FL 32114-2781
Phone (386) 425-0393

3300 E Halifax Crossing Blvd
Deltona, FL 32725-2911
Phone (386) 425-6100

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone (386) 238-3200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting57
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME103969FLMDInternal Medicine Physician
239076NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Apr 8, 2013 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Apr 8, 2013 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Apr 23, 2013 Accepting new patients
West Florida Cardiology Network, LLC Cardiovascular Disease PastSince Jan 1, 2011 Accepting new patients
Cardiology Consultants Past Accepting new patients

Locations

350 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 238-3200

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

350 N Clyde Morris Blvd
Ste 1
Daytona Beach, FL 32114
Phone (386) 238-3289

309 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 445-7073

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4692/brand/27/csg/1/fhir/r4
  • Direct secure messaging: stephenminor@fhcpfl.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1851309629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9671",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209671",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 1",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-238-3289",
            "fax_number": "386-238-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239076",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME103969",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME103969",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME103969",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00913614",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1851309629",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001218000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "145H9",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.