Diana Medina, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

91-PA07 Issued in NM

Practice address

2025 Galisteo St
Santa Fe, NM 87505-2101

Phone

(505) 995-4901

Fax

(505) 989-6426

NPI assigned

May 27, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley-Wide Health Systems, Inc.Group PAC ID 5991609067, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008
• San Luis Valley Health Conejos County Hospital Hospital, La Jara, CO, CCN 061308
• Rio Grande Hospital Hospital, Del Norte, CO, CCN 061301

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: diana.medina.p1@direct.vwhs.nextgenshare.com

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.

• Valley-Wide Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1790998953
  Medicare reassignment Care Compare group NPD
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1205652047
  NPD
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Canon City, CO
  • NPI 1215383500
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lutheran Hospital Association of the San Luis Valley

  • Critical Access Hospital Clinic/Center
  • La Jara, CO
  • NPI 1194792762
  Care Compare affiliation
• Lutheran Hospital Association of the San Luis Valley

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation
• Valley Citizens' Foundation for Health Care Inc

  • Critical Access Hospital
  • Del Norte, CO
  • NPI 1396783981
  Care Compare affiliation
• Valley Citizens' Foundation for Health Care Inc

  • Critical Access Hospital Clinic/Center
  • South Fork, CO
  • NPI 1699266718
  Care Compare affiliation
• Valley Citizens' Foundation for Health Care Inc

  • Critical Access Hospital Clinic/Center
  • Creede, CO
  • NPI 1851882989
  Care Compare affiliation

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1104873082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "505-995-4901",
            "fax_number": "505-989-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "505-995-4901",
            "fax_number": "505-989-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "91-PA07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMYPR0068422",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PLANS",
            "identifier": "201006707",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98151",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meadow Speech Therapy LLC
• Sarah G Meadows, LMSW
• Meaningful Change Learning Services, LLC
• Brandon Medina
• Danielle Medina
• Jeffery Michael Medina, RN
• Juan Medina
• Julie Darlene Medina, TEACHER
• Leasa Medina, LCSW
• Brenda Berenice Medina, LPCC, LPCC

• Physician Assistant in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.