Individual provider Active NPI

Abelardo Medina, MD

  • Plastic Surgery Physician
  • Augusta, GA
National Provider Identifier
1003306135
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
95270 Issued in GA
Practice address
3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
May 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 95270 GA Primary

Addresses

Primary practice location

3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868

Mailing address

PO Box 3726
Augusta, GA 30914-3726
Phone (706) 863-9595

Other practice location 1

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 863-9595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180803001787 MS Practitioner - Plastic and Reconstructive Surgery 7618225806 Reassigns benefits to 1 organization
I20230823001882 GA Practitioner - Plastic and Reconstructive Surgery 7618225806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph M Still Burn Centers, IncGroup PAC ID 7618963638, 47 clinicians

Practice addresses (Care Compare)

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 863-9595

Hospital & facility affiliations

  • Doctors Hospital Hospital, Augusta, GA, CCN 110177

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue13
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince May 25, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince May 25, 2018 Accepting new patients
Doctors Hospital of Augusta LLC Past Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

2500 N State St
#2525
Jackson, MS 39216

1850 Chadwick Dr
Ste 1427
Jackson, MS 39204
Phone (877) 863-9595

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1003306135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR STE 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3651 Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096521",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ABELARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "95270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.