Individual provider Active NPI

Edwing Gerardo Medina Carcamo, M.D.

  • Internal Medicine Physician
  • Trenton, NJ
National Provider Identifier
1184889271
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08361900 Issued in NJ
Practice address
750 Brunswick Ave
Trenton, NJ 08638-4143
Phone
(609) 394-6000
NPI assigned
Jul 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 25MA08361900 NJ
Internal Medicine Physician 207R00000X 25MA08361900 NJ Primary

Addresses

Primary practice location

750 Brunswick Ave
Trenton, NJ 08638-4143

Mailing address

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

Other identifiers 1

IdentifierTypeStateIssuer
0195901MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Edwin.Medina.Carcamo@capitalhealth.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090720000156 NJ Practitioner - Internal Medicine 6103978390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Multispecialty GroupGroup PAC ID 1850689894, 342 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

Hospital & facility affiliations

  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Multispecialty Group Internal Medicine CurrentSince Nov 28, 2018 Accepting new patients
Capital Health System, Inc. Past Accepting new patients
Capital Health System Inc Past Accepting new patients

Locations

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

3131 Princeton Pike
Bldg 6C
Lawrenceville, NJ 08648
Phone (609) 896-9704

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

Interoperability endpoints

  • Direct secure messaging: edwin.medina.carcamo@capitalhealth.cernerdirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/5bb47b8f-8587-42a0-80df-8d4eecf69db3/

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1184889271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAPITAL WAY",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342520",
            "telephone_number": "609-303-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BRUNSWICK AVE",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384143",
            "telephone_number": "609-394-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA CARCAMO",
        "first_name": "EDWING",
        "middle_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NJ",
            "license": "25MA08361900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08361900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0195901",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Edwin.Medina.Carcamo@capitalhealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "750 Brunswick Ave",
            "city": "Trenton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086384143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.