Individual provider Active NPI

John Regis Minotti, M.D.

  • Cardiovascular Disease Physician
  • Lakeport, CA
National Provider Identifier
1932107828
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C39966 Issued in CA
Practice address
801 11TH St
Lakeport, CA 95453-4100
Phone
(707) 263-3746
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X C39966 CA
Cardiovascular Disease Physician 207RC0000X C39966 CA Primary

Addresses

Primary practice location

801 11TH St
Lakeport, CA 95453-4100

Mailing address

801 11TH St
Lakeport, CA 95453-4100
Phone (707) 263-3746

Other identifiers 3

IdentifierTypeStateIssuer
00C399660MedicaidCA
060067540OtherCARAILROAD MEDICARE
00C399660OtherCABLUE SHIELD OF CALIFORNIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040603000878 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1456333483 Reassigns benefits to 1 organization
Practice locations: Lakeport, CA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Clearlake Hospital Inc. CurrentSince Oct 15, 2022 Accepting new patients

Locations

15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

801 11th St
Lakeport, CA 95453
Phone (707) 263-3746

475 N Forbes St
Lakeport, CA 95453
Phone (707) 263-6346

487 S Main St
Lakeport, CA 95453
Phone (707) 263-4360

821 Saint Helena Hwy S
#208
Saint Helena, CA 94574

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1932107828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 11TH ST",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534100",
            "telephone_number": "707-263-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 11TH ST",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534100",
            "telephone_number": "707-263-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOTTI",
        "first_name": "JOHN",
        "middle_name": "REGIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "C39966",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C39966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C399660",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060067540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00C399660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.