DR. DAVID P JR. MINICHAN (M.D.) – Specialist, NPI 1144212705

DR. DAVID P JR. MINICHAN (M.D.) is a healthcare provider. based in Roanoke, Virginia. specializing in Specialist. They hold the professional credentials M.D.. They hold a License No. 0101012581 (VA). The NPI Number for DR. DAVID P JR. MINICHAN (M.D.) is 1144212705

Main info

Male
71 Years Of Experience
Accepts Medicare Assignment
Name
DR. DAVID P JR. MINICHAN (M.D.)
NPI
1144212705
Phone
(540) 345-1561
Address
1234 FRANKLIN RD SW
Enumeration Date
19 August 2005
Last Update Date
4 September 2009

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
4349473900
Graduation Year
1955 (71 years ago)
PAC ID
8729134424
Group Practice PAC ID
7315108511
Professional Enrollment ID
I20090922000461
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. DAVID P JR. MINICHAN (M.D.)

  • Jefferson Surgical Clinic, 1234, Franklin Road Southwest, Old Southwest, Roanoke, Roanoke (city), Virginia, 24014, United States

    ROANOKE, VA 240164606

    Phone: (540) 345-1561

    Fax: (540) 345-2112

    Mailing address matches the actual address.

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: 2009-09-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20090922000461IGeneral SurgeryVATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 24016)

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Provider's Procedures

DR. DAVID P JR. MINICHAN (M.D.) performs procedures in Specialist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL SURGERYVA45378Diagnostic examination of large bowel using an endoscope4949
GENERAL SURGERYVA45385Removal of polyps or growths of large bowel using an endoscope1212

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: 7315108511View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to DR. DAVID P JR. MINICHAN (M.D.)?
NPI 1144212705 is assigned to DR. DAVID P JR. MINICHAN (M.D.) under the national enumeration system.
Is DR. DAVID P JR. MINICHAN (M.D.) active in the national directory?
DR. DAVID P JR. MINICHAN (M.D.)'s public NPI profile is in an active state.
Can you summarize DR. DAVID P JR. MINICHAN (M.D.)'s specialty in plain language?
Clinically, the directory lists DR. DAVID P JR. MINICHAN (M.D.) with Other Service Providers. Clinical services aligned with this taxonomy classification.
Does DR. DAVID P JR. MINICHAN (M.D.) practice in Virginia?
You will see Roanoke, Virginia on file for DR. DAVID P JR. MINICHAN (M.D.) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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