Active NPI
Patricia Medina, PT
- Physical Therapist
- Jackson Heights, NY
National Provider Identifier
1124117767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 023916
- Practice address
- 8201 37TH Ave
4TH Floor
Jackson Heights, NY 11372-7011 - Phone
- (718) 424-0303
- Fax
- (718) 424-0920
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 023916 | NY | Primary |
Addresses
Primary practice location
8201 37TH Ave
4TH Floor
Jackson Heights, NY 11372-7011
Mailing address
8201 37TH Ave
4TH Floor
Jackson Heights, NY 11372-7011
Phone (718) 424-0303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02426204 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023916 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124117767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8201 37TH AVE",
"address_2": "4TH FLOOR",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727011",
"telephone_number": "718-424-0303",
"fax_number": "718-424-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8201 37TH AVE",
"address_2": "4TH FLOOR",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727011",
"telephone_number": "718-424-0303",
"fax_number": "718-424-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "PATRICIA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "023916",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02426204",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.