MR. AJAY MINTON (PA) – Physician Assistant, NPI 1104586833

MR. AJAY MINTON (PA) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2023005151 (MO). The NPI Number for MR. AJAY MINTON (PA) is 1104586833

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
MR. AJAY MINTON (PA)
NPI
1104586833
Phone
(309) 883-0740
Address
1209 WASHINGTON AVE APT 413
Enumeration Date
21 December 2021
Last Update Date
17 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3149612255
Graduation Year
2022 (4 years ago)
PAC ID
2365815362
Group Practice PAC ID
8820171929
Professional Enrollment ID
I20230222000276
Address ID
MO633688230OX4201XKXXX300
Telehealth
Yes

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

1,854 PHYSICIAN ASSISTANT in MO

Provider Addresses for MR. AJAY MINTON (PA)

  • 1209 WASHINGTON AVE APT 413

    SAINT LOUIS, MO 631032012

    Phone: (309) 883-0740

    Type: Mailing

  • 3437 CAROLINE ST

    SAINT LOUIS, MO 631041111

    Phone: (309) 883-0740

    Type: Location

  • PO BOX 7412011

    CHICAGO, IL 606742011

    Phone: (314) 362-9123

    Fax: (314) 747-3338

    Type: Mailing

  • 400 S KINGSHIGHWAY BLVD

    DEPT EMERGENCY MED

    SAINT LOUIS, MO 631101014

    Phone: (314) 362-9123

    Fax: (314) 747-3338

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230222000276IPhysician AssistantMOTBD
I20240911002902IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99292Critical care, each additional 30 minutes22950$0
J1100Injection, dexamethasone sodium phosphate, 1 mg11820$0
99291Critical care, first 30-74 minutes9855$0
99214Established patient office or other outpatient visit, 30-39 minutes5656$0
87635Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen3636$0
View full utilization report →

Insurance plans in this area (ZIP 63103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820171929View full group profile

Reviews

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Frequently asked questions

Can I verify MR. AJAY MINTON (PA) with an NPI only?
You can start verification with NPI 1104586833 for MR. AJAY MINTON (PA), then check state licensing separately.
Can I rely on MR. AJAY MINTON (PA) being an active provider?
As of the registry snapshot, MR. AJAY MINTON (PA) is marked active.
What taxonomy line describes MR. AJAY MINTON (PA)?
For research purposes, treat MR. AJAY MINTON (PA) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect MR. AJAY MINTON (PA) on a map?
Expect Saint Louis, Missouri as a primary anchor for MR. AJAY MINTON (PA) unless the record lists multiple sites.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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