Individual provider Active NPI

Alejandro A. Medina, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Bayamon, PR
National Provider Identifier
1093867368
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
11421 Issued in PR
Practice address
Calle Isabel II, Edificio Joaquin Montesino
Oficina 103 B
Bayamon, PR 00961
Phone
(787) 780-5930
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 11421 PR Primary

Addresses

Primary practice location

Calle Isabel II, Edificio Joaquin Montesino
Oficina 103 B
Bayamon, PR 00961

Mailing address

Me32 Plaza 17
Monte Claro
Bayamon, PR 00961-4792
Phone (787) 780-5930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20040310000830 PR Practitioner - Family Practice 3274421102 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Calle Isabel II Ofic
107 Edificio Joaquin Montes
Bayamon, PR 00961
Phone (787) 780-5930

Me32 Plaza
Suite 17
Bayamon, PR 00961

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayamon Family & Geriatric Medical Clinic, LLC Past Accepting new patients
Tanuis Health Services Corp PastSince May 3, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1093867368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ME32 PLAZA 17",
            "address_2": "MONTE CLARO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009614792",
            "telephone_number": "787-780-5930",
            "fax_number": "787-780-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ISABEL II, EDIFICIO JOAQUIN MONTESINO",
            "address_2": "OFICINA 103 B",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-780-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ALEJANDRO",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "11421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.