Individual provider Active NPI

Michael V Medina, MD

  • Otolaryngology Physician
  • Dallas, TX
National Provider Identifier
1093979783
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
V9367 Issued in TX
Practice address
7115 Greenville Ave Ste 210
Dallas, TX 75231-5104
Phone
(214) 696-4696
Fax
(214) 696-4699
NPI assigned
Jul 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MT187464 PA
Otolaryngology Physician 207Y00000X ME105786 FL
Otolaryngology Physician 207Y00000X V9367 TX Primary

Addresses

Primary practice location

7115 Greenville Ave Ste 210
Dallas, TX 75231-5104

Mailing address

7115 Greenville Ave Ste 210
Dallas, TX 75231-5104
Phone (214) 696-4696

Other identifiers 1

IdentifierTypeStateIssuer
001696700MedicaidFL

Other names 1

  • Dr. Michael Victorino F Medina Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260422001100 TX Practitioner - Otolaryngology 0345385001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sinus Registry PLLCGroup PAC ID 1456506807, 3 clinicians

Practice addresses (Care Compare)

7115 Greenville Ave
Suite 210
Dallas, TX 75231-5104
Phone (214) 696-4696

Hospital & facility affiliations

  • Cleveland Clinic Hospital Hospital, Weston, FL, CCN 100289
  • Texas Institute for Surgery at Presbyterian Hospit Hospital, Dallas, TX, CCN 450889

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT187464PAMDOtolaryngology Physician
V9367TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmedina151186@direct.ccf.org
  • Direct secure messaging: michael.medina.1@8082.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1093979783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 GREENVILLE AVE STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315104",
            "telephone_number": "214-696-4696",
            "fax_number": "214-696-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 GREENVILLE AVE STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315104",
            "telephone_number": "214-696-4696",
            "fax_number": "214-696-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MICHAEL",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MT187464",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME105786",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "V9367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001696700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL VICTORINO",
            "last_name": "MEDINA",
            "middle_name": "F",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.