Active NPI
Mark W Minor, MD
- Allergy Physician
- Melbourne, FL
National Provider Identifier
1982609657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- ME0045859
- Practice address
- 3021 W Eau Gallie Blvd Ste 102
Melbourne, FL 32934-7005 - Phone
- (321) 757-5550
- Fax
- (321) 255-5552
- NPI assigned
- Jun 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | ME0045859 | FL | Primary |
Addresses
Primary practice location
3021 W Eau Gallie Blvd Ste 102
Melbourne, FL 32934-7005
Mailing address
3021 W Eau Gallie Blvd Ste 102
Melbourne, FL 32934-7005
Phone (321) 757-5550
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1762243003 | Other | FL | CIGNA |
| 4038851 | Other | FL | AETNA |
| 26075 | Other | FL | BCBS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041208000133 | FL | Practitioner - Allergy/Immunology | 1456317775 |
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- West Virginia University School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2200 W Eau Gallie Blvd
Suite 200
Melbourne, FL 32935-3145
2200 W Eau Gallie Blvd
Suite 200
Melbourne, FL 32935-3166
5732 Cypress Creek Dr
Grant, FL 32949-8306
Hospital & facility affiliations
- Holmes Regional Medical Center
- Viera Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.59 of 100
- Quality
- 97.17
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0045859 | FL | MD | Allergy Physician |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IGFJBD/Endpoint/IGFJBD
- mminor71631@epicdirect.hf.org
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1730494816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742342400000",
"number": "1982609657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3021 W EAU GALLIE BLVD STE 102",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329347005",
"telephone_number": "321-757-5550",
"fax_number": "321-255-5552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3021 W EAU GALLIE BLVD STE 102",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329347005",
"telephone_number": "321-757-5550",
"fax_number": "321-255-5552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINOR",
"first_name": "MARK",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2025-03-19",
"certification_date": "2025-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "FL",
"license": "ME0045859",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1762243003",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4038851",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "26075",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.