Active NPI
Jannette Medina, PNP
- Pediatrics Physician
- Bronx, NY
National Provider Identifier
1194524926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- F-383560
- Practice address
- 1055 E Tremont Ave
Bronx, NY 10460-2306 - Phone
- (917) 297-6842
- NPI assigned
- Mar 12, 2025
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | F-383560 | NY | Primary |
Addresses
Primary practice location
1055 E Tremont Ave
Bronx, NY 10460-2306
Mailing address
76 Brookside Ave Unit 23
Chester, NY 10918-7502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F-383560 | NY | MD | Pediatrics Physician |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EJHEAA/Endpoint/EJHEAA
- https://fhir4.healow.com/fhir/r4/FEBFAA/Endpoint/FEBFAA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741737600000",
"number": "1194524926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 BROOKSIDE AVE UNIT 23",
"city": "CHESTER",
"state": "NY",
"postal_code": "109187502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104602306",
"telephone_number": "917-297-6842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "JANNETTE",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-12",
"last_updated": "2025-03-12",
"certification_date": "2025-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "F-383560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.