Individual provider Active NPI

Sol Lissette Rodriguez Medina, MD

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1205093929
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
256464 Issued in NY
Practice address
3424 Kossuth Avenue
Bronx, NY 10467
Phone
(718) 519-5000
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 050348 CT
Psychiatry Physician 2084P0800X 256464 NY Primary

Addresses

Primary practice location

3424 Kossuth Avenue
Bronx, NY 10467

Mailing address

3424 Kossuth Avenue
Bronx, NY 10467
Phone (718) 519-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110331000937 NY Practitioner - Psychiatry 5496938268 Reassigns benefits to 2 organizations
I20140116000937 CT Practitioner - Psychiatry 5496938268 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley Psychiatry CurrentSince Feb 15, 2025 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients
Garnet Health Doctors PC CurrentSince Jan 6, 2025 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Feb 15, 2025 Accepting new patients
Northeast Medical Group, Inc. Psychiatry CurrentSince Feb 1, 2022 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Feb 1, 2022 Accepting new patients
State of Connecticut CurrentSince Jan 1, 2021 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Sep 12, 2021 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Sep 12, 2021 Accepting new patients
State of Connecticut CurrentSince Jan 1, 2021 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

130 Division St
Derby, CT 06418
Phone (203) 732-1330

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: sollissette.rodriguezmedina@xdr.hhchealthdirect.org

Organizations & group practices 11

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1205093929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-519-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-519-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ MEDINA",
        "first_name": "SOL LISSETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "050348",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "256464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.