Aiesha-Agyemarai Medina, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5490 Issued in PR

Practice address

Carr.324 KM. 2.1 Bo. Ensenada El Batey
Guanica, PR 00653

Phone

(787) 821-5328

NPI assigned

Aug 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Migrant Health Center Western Region,IncGroup PAC ID 4183520810, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Migrant Health Center Western Region,Inc

  • Federally Qualified Health Center (FQHC)
  • Mayaguez, PR
  • NPI 1609969286
  Medicare reassignment Care Compare group NPD
• Migrant Health Center Western Region, Inc.

  • Clinic Pharmacy
  • Yauco, PR
  • NPI 1093262297
  NPD
• Migrant Health Center Western Region Inc

  • Clinic Pharmacy
  • San Sebastian, PR
  • NPI 1114064102
  NPD (past)
• Migrant Health Center Western Region, Inc.

  • Radiology Clinic/Center
  • Las Marias, PR
  • NPI 1508453051
  NPD (past)

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1225765688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5000-452",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "939-942-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR.324 KM. 2.1 BO. ENSENADA EL BATEY",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "00653",
            "telephone_number": "787-821-5328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Jardines de Fagot",
            "address_2": "Calle Manzanilla # I 20",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "00716",
            "country_code": "US",
            "telephone_number": "939-642-1463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "AIESHA-AGYEMARAI",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "5490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loang Corp
• Gabriela Enid Luciano, PSYD
• Lisbeth Lugo
• Maria R. Suarez MD,CSP
• Jackeline Mattei, O.T.
• Wilson Mendez, OPTICIAN
• Joan Marie Mercado Garcia, LMT
• Midnight Psychology Group LLC.
• Migrant Health Center
• Migrant Health Center Western Region, Inc.

• Clinical Psychologist in Guanica, PR
• Providers in Guanica, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.

Verify at the official NPI Registry.