Alexis Brooke Mincer, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

OA006847 Issued in PA

Practice address

9908 Roosevelt Blvd
Philadelphia, PA 19115

Phone

(215) 464-2902

Fax

(215) 464-2954

NPI assigned

Jan 15, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Physicians Group LLCGroup PAC ID 2769631621, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mincer@ppg-pa.direct.office.nextgen.com

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.

• Pinnacle Physicians Group LLC

  • Family Medicine Physician
  • Trevose, PA
  • NPI 1184984809
  Medicare reassignment Care Compare group
• Patient First Maryland Physician'S Group PC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1982733564

  NJ

  Medicare reassignment NPD
• Patient First Pennsylvania Medical Group PLLC

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1194039560

  PA

  Medicare reassignment NPD
• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment
• Patient First Pennsylvania Medical Group PLLC

  • Family Medicine Physician
  • Fairless Hills, PA
  • NPI 1144870387
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• University of Penn-Medical Group

  • Hospitalist Physician
  • Philadelphia, PA
  • NPI 1992301196
  NPD
• Patients First Maryland Physicians Group P C

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1114477270
  NPD

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

{
    "created_epoch": "1326585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1982975454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 REVELATION RD",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190461022",
            "telephone_number": "610-203-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9908 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-464-2902",
            "fax_number": "215-464-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINCER",
        "first_name": "ALEXIS",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-15",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056041",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA006847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Giovanni Mina, DPM
• Michael S Mina, R.PH.
• Kenji Minakata, MD
• Brian Andrew Minarcik, D.O
• Minard Duka DMD PC
• Bohdan M Minczak, MD
• Mind Belly Soul Nutrition LLC
• Mind Body Nourish LLC
• Mind Power Counseling LLC
• Jodi Mindell, PH.D.

• Medical Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.

Verify at the official NPI Registry.