Individual provider Active NPI

Celina Medicina, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1043103799
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24740 Issued in FL
Practice address
419 SE 2ND St
Fort Lauderdale, FL 33301-2076
Phone
(954) 651-0914
NPI assigned
Jun 2, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW24740 FL Primary

Addresses

Primary practice location

419 SE 2ND St
Fort Lauderdale, FL 33301-2076

Mailing address

419 SE 2ND St
Fort Lauderdale, FL 33301-2076
Phone (954) 651-0914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, MN, TX, FL, ND, UT6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20260115000681 AK Practitioner - Clinical Social Worker 0446736862 Reassigns benefits to 3 organizations
I20260120000841 MN Practitioner - Clinical Social Worker 0446736862 Reassigns benefits to 1 organization
I20260303000219 TX Practitioner - Clinical Social Worker 0446736862 Reassigns benefits to 1 organization
I20260407001685 FL Practitioner - Clinical Social Worker 0446736862
I20260505002715 ND Practitioner - Clinical Social Worker 0446736862 Reassigns benefits to 1 organization
I20260522002758 UT Practitioner - Clinical Social Worker 0446736862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peterson Medical Clinics LLCGroup PAC ID 9335412220, 91 clinicians

Practice addresses (Care Compare)

205 E Benson Blvd
Suite 401
Anchorage, AK 99503-4019
Phone (701) 205-3000

3674 S Washington St
Grand Forks, ND 58201-5766
Phone (701) 205-3000

519 Anne St NW
Suite a
Bemidji, MN 56601-4277
Phone (701) 205-3000

64 E 100
Gunnison, UT 84634-7709
Phone (701) 205-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW24740FLMDClinical Social Worker
35744MNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation CurrentSince Jan 13, 2026 Accepting new patients
Norton Sound Health Corporation CurrentSince Dec 30, 2025 Accepting new patients
Norton Sound Health Corporation CurrentSince Dec 30, 2025 Accepting new patients
Peterson Medical Clinics, LLC CurrentSince Dec 30, 2025 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jan 27, 2026 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jan 27, 2026 Accepting new patients

Locations

205 E Benson Blvd
Ste 401
Anchorage, AK 99503

519 Anne St NW
Ste A
Bemidji, MN 56601
Phone (218) 444-5700

4501 15th Ave SW
Ste 105
Fargo, ND 58103

3674 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2538

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1043103799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 SE 2ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012076",
            "telephone_number": "954-651-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 SE 2ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012076",
            "telephone_number": "954-651-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDICINA",
        "first_name": "CELINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.