Juan M Medina, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Practice address

320 S Locust St
Carlinville, IL 62626-1748

Phone

(217) 854-3166

NPI assigned

May 19, 2006

Last updated

Mar 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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 IL

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

Specialty

Psychiatry

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Associates of Central Illinois LTDGroup PAC ID 1355318825, 7 clinicians

Locust Street Resource CenterGroup PAC ID 6002846599, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Locust Street Resource Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carlinville, IL
  • NPI 1558456210
  Medicare reassignment Care Compare group NPD
• Psychological Associates of Central Illinois LTD

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1376698050
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1265485106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S LOCUST ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261648",
            "telephone_number": "217-854-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S LOCUST ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261748",
            "telephone_number": "217-854-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JUAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Perry, LCSW
• Jane McFarland, LCPC
• Elizabeth McIntosh, LCSW
• Kelly McLaughlin, R.N.
• Matthew McPherson, R.D.
• Elaine Marsha Miller
• Jill Christine Miller, COTA/L
• Amy Marie Murphy, P.T., D.P.T.
• Sarah Myers-Eller, COTA/L
• Margaret E Nepute, MSW

• Psychiatry Physician in Carlinville, IL
• Providers in Carlinville, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.