Edmond Medina, MD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

095 Issued in PR

Practice address

P12 Ave Magnolia
Bayamon, PR 00956-2608

Phone

(787) 785-9282

Fax

(787) 785-9290

NPI assigned

Oct 12, 2005

Sex

Male

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: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Ohio State University College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Bayamon Podiatric Clinic PSC

  • Foot & Ankle Surgery Podiatrist
  • Bayamon, PR
  • NPI 1306421714
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1275521312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ME8 PLAZA 12",
            "address_2": "URB. MONTE CLARO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009614776",
            "telephone_number": "787-785-9282",
            "fax_number": "787-785-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "P12 AVE MAGNOLIA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009562608",
            "telephone_number": "787-785-9282",
            "fax_number": "787-785-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EDMOND",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PR",
            "license": "095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sixto Manuel Medina Jaca, MD
• Noriana Liz Medina Ortiz, LCDA
• Jose T. Medina-Tollinche, MD
• Alejandro A. Medina, M.D.
• Camila M Medina, M.S., LSSP.
• Fernando Medina, DR.
• Gerarda Medina, RN,BSN
• Jean Medina, DC
• Legna Noemi Medina, OTL
• Leilanie Medina, PHARM. D.

• Podiatrist in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Podiatrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.