MR. SAMUEL ANTHONY MINAKER (M.D.) – Ophthalmology Physician, NPI 1174194955

MR. SAMUEL ANTHONY MINAKER (M.D.) is a healthcare provider. based in Tyler, Texas. specializing in OPHTHALMOLOGY. They hold the professional credentials M.D.. They hold a License No. V9664 (TX). The NPI Number for MR. SAMUEL ANTHONY MINAKER (M.D.) is 1174194955

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MR. SAMUEL ANTHONY MINAKER (M.D.)
NPI
1174194955
Phone
(773) 590-9184
Address
4539 CASCADES SHORELINE DR
Enumeration Date
2 July 2021
Last Update Date
1 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3129425315
Graduation Year
2016 (10 years ago)
PAC ID
2961806112
Group Practice PAC ID
2567411325
Professional Enrollment ID
I20210810004093
Address ID
IL606123848CH1725XSTXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:4State licenses:3Digital endpointsOther names

1,544 OPHTHALMOLOGY in TX

Provider Addresses for MR. SAMUEL ANTHONY MINAKER (M.D.)

  • 4539 CASCADES SHORELINE DR

    TYLER, TX 757098902

    Phone: (773) 590-9184

    Type: Mailing

  • 1201 W GRANDE BLVD

    TYLER, TX 757036124

    Phone: (903) 597-4644

    Fax: (903) 266-9449

    Type: Location

  • 11516 183RD PL STE SW

    ORLAND PARK, IL 604679471

    Phone: (708) 877-1300

    Fax: (708) 596-8719

    Type: Mailing

  • 71 W 156TH ST

    STE 400

    HARVEY, IL 604264265

    Phone: (708) 596-8710

    Fax: (708) 915-2798

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 63 Open Payments records for all available years, with a total value of $20,312.

Total Amount is formed as General ($20,312) + Research ($0) + Ownership ($0) = $20,312.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Ocular Therapeutix, Inc. ($6,594).

Total Amount

$20,312

General + Research + Ownership

Payments

63

Total payment records

General Amount

$20,312

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20210810001725IOphthalmologyINTBD
I20210810004093IOphthalmologyILTBD
I20250917000150IOphthalmologyTXTBD

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
92134Imaging of retina205176$0
J0178Injection, aflibercept, 1 mg12648$0
67028Injection of drug into eye9678$0
92014Established patient complete exam of visual system7672$0
92004New patient complete exam of visual system4242$0
View full utilization report →

Insurance plans in this area (ZIP 75709)

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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: 2567411325View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YIL
Ophthalmology, Internal MedicineOH
O P H T H A L M O L O G YIL
O P H T H A L M O L O G YTX

Reviews

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Frequently asked questions

Is MR. SAMUEL ANTHONY MINAKER (M.D.) listed with a National Provider Identifier?
Yes — MR. SAMUEL ANTHONY MINAKER (M.D.) has NPI 1174194955 on file in the registry.
Is there an active status for MR. SAMUEL ANTHONY MINAKER (M.D.)?
For scheduling context, MR. SAMUEL ANTHONY MINAKER (M.D.) is shown as active in the registry.
What area of care is associated with MR. SAMUEL ANTHONY MINAKER (M.D.)?
MR. SAMUEL ANTHONY MINAKER (M.D.)'s record emphasizes Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Is MR. SAMUEL ANTHONY MINAKER (M.D.) located near Tyler?
MR. SAMUEL ANTHONY MINAKER (M.D.) currently maps to Tyler, Texas in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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