Timothy J Mineo (NPI# 1275730459, PAC ID# 1557487444) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1275730459 |
| PAC ID by PECOS | 1557487444 |
| Professional Enrollment ID | I20100928001644 |
| Full Name | Timothy J Mineo |
| Organization Legal Name | EASTSIDE FOOT AND ANKLE |
| Address |
1717 Ne 42nd Ave Suite 3300 Portland OR 97213-1572 |
| Phone Number | 5032842000 |
| Gender | M |
| Graduation Year | 2007 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 4284983016 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380025 | LEGACY MOUNT HOOD MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213-1572 | 5032842000 | EASTSIDE FOOT AND ANKLE |
| Organization Legal Name | EASTSIDE FOOT AND ANKLE |
| Physicians | 1 |
| Street Address |
1717 NE 42ND AVE SUITE 3300 |
| City | PORTLAND |
| State | OR |
| Zip | 97213-1572 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian M Bowen | Podiatry | 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213-1572 | |
| David B Russ | Chiropractic | 1717 Ne 42nd Ave, Suite 3200, Portland, OR 97213-1572 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John R Lewis | Optometry | Beaumont Vision, PC | 4331 Ne Fremont St, Portland, OR 97213-1151 |
| David M Klipper | Diagnostic Radiology | Kern Radiology Medical Group Inc | 4231 Ne Siskiyou St, Portland, OR 97213-1161 |
| Evonne N Serpa | Qualified Audiologist | 4311 Ne Tillamook St, Portland, OR 97213-1315 | |
| Judith J Chambers | Clinical Social Worker | 1804 Ne 45th Ave, Portland, OR 97213-1416 | |
| Diane Squire Hyde | Clinical Social Worker | 1804 Ne 45th Ave, Portland, OR 97213-1416 | |
| Marjorie J Hrbek | Internal Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Mary Lee Baker | Pediatric Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Lorelei Elizabeth Ditommaso | Dermatology | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Tracy L Hansen | Internal Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Anne M Hirsch | Internal Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Find all physicians in zip 97213 | |||
| City | PORTLAND |
| Zip Code | 97213 |
| Specialty | PODIATRY |
| City + Specialty | PORTLAND + PODIATRY |
Please comment or provide details below to improve the information on Timothy J Mineo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.