Grace M Medina, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14864 Issued in PR

Practice address

Ave El Jibaro Carr 172 KM 13.5
Cidra, PR 00739

Phone

(787) 739-8182

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGGFBD

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.

• Cossma

  • Primary Care Clinic/Center
  • Cidra, PR
  • NPI 1184026221
  NPD (past)
• Cossma, Inc.

  • Clinical Medical Laboratory
  • Humacao, PR
  • NPI 1407408347
  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1114585098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007391330",
            "telephone_number": "787-739-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE EL JIBARO CARR 172 KM 13.5",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "00739",
            "telephone_number": "787-739-8182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "URB Santa Rosa",
            "address_2": "A8 Calle Diana",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "00725",
            "country_code": "US",
            "telephone_number": "939-277-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "GRACE",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "14864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184026221",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guillermo F Martinez, M.D.
• Medical Family
• Medical Family Center
• Medical Family Center Corp.
• Edwin Joel Medina Agosto, PSYCHOLOGIST
• Medwell Center, LLC
• Jose Enrique Melendez
• Yolyedmy Waleska Melendez, RPH
• Ruben Mendez Benabe, MD
• Angelie Mendez Fernandez, P.T.A., B.H.E

• Clinical Social Worker in Cidra, PR
• Providers in Cidra, PR by specialty
• Clinical Social Worker in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.