Active NPI
Isis M Medina, DC
- Chiropractor
- New York, NY
National Provider Identifier
1174653190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X003428
- Practice address
- 115 East 23Rd St
6TH Floor
New York, NY 10010 - Phone
- (212) 228-5600
- Fax
- (212) 475-0703
- NPI assigned
- Mar 7, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X003428 | NY | Primary |
Addresses
Primary practice location
115 East 23Rd St
6TH Floor
New York, NY 10010
Mailing address
23 Adams St
Garden City, NY 11530
Phone (516) 437-1330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120306000181 | NY | Practitioner - Chiropractic | 3072772342 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1982
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
119 W 23Rd St
New York, NY 10011-6344
Phone (212) 989-9800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003428 | NY | MD | Mental Health Counselor |
| X003428 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174653190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 ADAMS ST",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "11530",
"telephone_number": "516-437-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 EAST 23RD ST",
"address_2": "6TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10010",
"telephone_number": "212-228-5600",
"fax_number": "212-475-0703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "ISIS",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X003428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.