Active NPI
Nikki Ann Reyes Medina, DO
- Obstetrics & Gynecology Physician
- Shelton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- OP70013962
- Practice address
- 1701 N 13TH St
Shelton, WA 98584-2077 - Phone
- (360) 426-2653
- NPI assigned
- Jun 5, 2021
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | OP70013962 | WA | Primary |
Addresses
Primary practice location
1701 N 13TH St
Shelton, WA 98584-2077
Mailing address
PO Box 1668
Shelton, WA 98584-5001
Phone (360) 426-2653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250916004338 | WA | Practitioner - Obstetrics/Gynecology | 9032514914 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
901 Mountain View Dr
Shelton, WA 98584-4401
PO Box
Seattle, WA 98124
Hospital & facility affiliations
- Mason General Hospital & Family of Clinics
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Hospital District No 1 of Mason County | Current | Accepting new patients | |
| Public Hospital District No 1 of Mason County Wa | Current | Accepting new patients | |
| Public Hospital District No 1 of Mason County | Current | Accepting new patients |
Locations
1710 N 13th Loop Rd
Shelton, WA 98584
Phone (360) 426-4142
1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653
901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611
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.
-
- Critical Access Hospital
- Shelton, WA
- NPI 1760568752
WA
-
- Family Medicine Physician
- Shelton, WA
- NPI 1063658953
-
- Clinic/Center
- Shelton, WA
- NPI 1316174774
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Shelton, WA
- NPI 1760568752
Hospital
-
- Foot & Ankle Surgery Podiatrist
- Shelton, WA
- NPI 1437486248
Hospital
-
- Surgery Physician
- Shelton, WA
- NPI 1639339666
Hospital
-
- Ophthalmologic Surgery Clinic/Center
- Shelton, WA
- NPI 1922196609
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776124800000",
"number": "1194392589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1668",
"city": "SHELTON",
"state": "WA",
"postal_code": "985845001",
"telephone_number": "360-426-2653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N 13TH ST",
"city": "SHELTON",
"state": "WA",
"postal_code": "985842077",
"telephone_number": "360-426-2653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "NIKKI ANN",
"middle_name": "REYES",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-05",
"last_updated": "2026-04-14",
"certification_date": "2026-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WA",
"license": "OP70013962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.