NPIMap

Individual provider Active NPI

Maria Ruby R Minosa, MD.

  • Family Medicine Physician
  • Burbank, CA
National Provider Identifier
1912972985
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A52727 Issued in CA
Practice address
191 S Buena Vista St
Suite 100
Burbank, CA 91505-4554
Phone
(855) 723-3005
Fax
(855) 817-9681
NPI assigned
Feb 22, 2006
Last updated
Mar 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A52727 CA Primary

Addresses

Primary practice location

191 S Buena Vista St
Suite 100
Burbank, CA 91505-4554

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5691

Other identifiers 1

IdentifierTypeStateIssuer
00A527270MedicaidCA

Other names 1

  • M. Ruby Minosa Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031118001195 CA Practitioner - Family Practice 7911811377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

191 S Buena Vista St
Suite 100
Burbank, CA 91505-4562
Phone (818) 869-7600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Family Medicine CurrentSince Mar 1, 2014 Accepting new patients
Providence Facey Medical Foundation CurrentSince Mar 1, 2014 Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

191 S Buena Vista St
Ste 100
Burbank, CA 91505
Phone (818) 869-7600

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: maria.minosa.p1@direct.lakeside.nextgenshare.com
  • Direct secure messaging: mminosa435804@oc.providencedirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1912972985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5691",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST",
            "address_2": "SUITE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054554",
            "telephone_number": "855-723-3005",
            "fax_number": "855-817-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOSA",
        "first_name": "MARIA RUBY",
        "middle_name": "R",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A52727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A527270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M. RUBY",
            "last_name": "MINOSA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.