Individual provider Active NPI

Tanya M Medina, MD

  • Family Medicine Physician
  • Saint Cloud, FL
National Provider Identifier
1023069960
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME84474 Issued in FL
Practice address
618 13TH St
Ste a
Saint Cloud, FL 34769-4503
Phone
(407) 556-3999
Fax
(407) 556-3933
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME84474 FL Primary

Addresses

Primary practice location

618 13TH St
Ste a
Saint Cloud, FL 34769-4503

Mailing address

618 13TH St
Stea
Saint Cloud, FL 34769-4503
Phone (407) 556-3999

Other identifiers 1

IdentifierTypeStateIssuer
270733100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050218000063 FL Practitioner - Family Practice 3173575263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers New Jersey Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

618 13TH St
Suite 101
Saint Cloud, FL 34769-4503
Phone (407) 556-3999

Hospital & facility affiliations

  • Orlando Health St Cloud Hospital Hospital, Saint Cloud, FL, CCN 100302
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J. Rapha Medical, PA CurrentSince Dec 1, 2004 Accepting new patients

Locations

618 13th St
Ste A
Saint Cloud, FL 34769
Phone (407) 556-3999

618 13th St
#101
Saint Cloud, FL 34769
Phone (407) 556-3999

618 13th St
Saint Cloud, FL 34769
Phone (407) 556-3999

Interoperability endpoints

  • Direct secure messaging: medina.tanya.001.0090102@owfms.meditab.direct-ci.com

Organizations & group practices 1

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 3

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1023069960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 13TH ST",
            "address_2": "STEA",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694503",
            "telephone_number": "407-556-3999",
            "fax_number": "407-556-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 13TH ST",
            "address_2": "STE A",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694503",
            "telephone_number": "407-556-3999",
            "fax_number": "407-556-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "TANYA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME84474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270733100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.