Jacqueline Medina

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

160 W 86TH St
New York, NY 10024-4018

Phone

(212) 875-1300

NPI assigned

May 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Center for Mental Health IncGroup PAC ID 6709798978, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Metropolitan Center for Mental Health, Inc.

  • Group Psychotherapy Psychologist
  • New York, NY
  • NPI 1275695371
  Medicare reassignment Care Compare group NPD
• Families and Individuals in Recovery

  • Addiction (Substance Use Disorder) Psychologist
  • New York, NY
  • NPI 1841354370
  NPD

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

{
    "created_epoch": "1651968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1003552522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5272 72ND ST FL 1",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781436",
            "telephone_number": "347-295-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W 86TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244018",
            "telephone_number": "212-875-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-08",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ibel A Medina, MS, CCC-SLP
• Indiana Medina, LMSW
• Irwin Medina, DDS
• Isis M Medina, DC
• Jackmary Medina
• Jamie Medina
• Janyll E Medina
• Julian Jeriel Medina, MD
• Karina Medina
• Kayla Medina, NP

• Mental Health Counselor in New York, NY
• Providers in New York, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.