Individual provider Active NPI

Ana L Medina, MD

  • Pediatrics Physician
  • Rio Piedras, PR
National Provider Identifier
1154304178
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5641 Issued in PR
Practice address
572 De Diego
Esquina Milan
Rio Piedras, PR 00924
Phone
(787) 754-9586
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5641 PR Primary

Addresses

Primary practice location

572 De Diego
Esquina Milan
Rio Piedras, PR 00924

Mailing address

12 Calle 1
Ext Alturas de San Patricio
Guaynabo, PR 00968-3128
Phone (787) 614-5440

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
I20140522001502 PR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3476776311

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1154304178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CALLE 1",
            "address_2": "EXT ALTURAS DE SAN PATRICIO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009683128",
            "telephone_number": "787-614-5440",
            "fax_number": "787-792-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 DE DIEGO",
            "address_2": "ESQUINA MILAN",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00924",
            "telephone_number": "787-754-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "5641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

Verify at the official NPI Registry.