Active NPI
David Anthony Minafo
- Community Health Worker
- Staten Island, NY
National Provider Identifier
1992074405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 010178-1
- Practice address
- 178 Morrison Ave
Staten Island, NY 10310-2835 - Phone
- (732) 416-6035
- Fax
- (732) 416-6035
- NPI assigned
- Dec 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 010178-1 | NY | Primary |
Addresses
Primary practice location
178 Morrison Ave
Staten Island, NY 10310-2835
Mailing address
178 Morrison Ave.
Staten Island, NY 10310
Phone (732) 416-6035
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497709166 | Other | NY | LIFESPIRE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010178-1 | NY | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332806400000",
"number": "1992074405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 MORRISON AVE.",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10310",
"telephone_number": "732-416-6035",
"fax_number": "732-416-6035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "178 MORRISON AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102835",
"telephone_number": "732-416-6035",
"fax_number": "732-416-6035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINAFO",
"first_name": "DAVID",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-29",
"last_updated": "2012-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NY",
"license": "010178-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIFESPIRE",
"identifier": "1497709166",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.