Individual provider Active NPI

Edlyane Veronica Medina Escobar, PHD

  • Clinical Psychologist
  • Richmond Hill, NY
National Provider Identifier
1184586133
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
027741 Issued in NY
Practice address
8900 Van Wyck Expy
Richmond Hill, NY 11418-2897
Phone
(718) 206-7262
NPI assigned
Nov 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 027741 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Richmond Hill, NY 11418-2897

Mailing address

8900 Van Wyck Expy
Richmond Hill, NY 11418-2897
Phone (718) 206-7262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260420001224 NY Practitioner - Clinical Psychologist 0840766655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

80 Marcus Dr
Melville, NY 11747-4230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027741NYMDClinical Psychologist

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1764288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1184586133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA ESCOBAR",
        "first_name": "EDLYANE",
        "middle_name": "VERONICA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-28",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "027741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.