Individual provider Active NPI

Mark W Minor, MD

  • Allergy Physician
  • Melbourne, FL
National Provider Identifier
1982609657
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
ME0045859 Issued in FL
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

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1762243003OtherFLCIGNA
4038851OtherFLAETNA
26075OtherFLBCBS

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
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 Hospital, Melbourne, FL, CCN 100019
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315

Merit-based Incentive Payment System (MIPS)

Final score
98.59 of 100Reported as individual
Quality
97.17
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0045859FLMDAllergy Physician

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGFJBD/Endpoint/IGFJBD
  • Direct secure messaging: mminor71631@epicdirect.hf.org

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.