Organization Active NPI

Nova Psychiatry Inc

  • Psychiatry Physician
  • Orlando, FL
National Provider Identifier
1285075739
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NOVA PSYCHIATRY INC
Practice address
1836 Woodward St
Orlando, FL 32803-4256
Phone
(407) 883-9303
Fax
(407) 641-9566
NPI assigned
Jul 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Authorized official

Name
David Antonio Medina, MDNPI 1588805824
Title
President
Phone
(407) 894-6980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1836 Woodward St
Orlando, FL 32803-4256

Mailing address

438 N Capen Ave
Winter Park, FL 32789-3013
Phone (407) 883-9303

Other identifiers 1

IdentifierTypeStateIssuer
005481100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131014000131 FL Part B Supplier - Clinic/Group Practice 6800020504 Receives reassigned benefits from 6 practitioners
Practice locations: Orlando, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2167972Nova Psychiatry Inc1836 Woodward Street Suite a, Orlando, FL 32803Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

717 E Oak St
Kissimmee, FL 34744
Phone (407) 846-0533

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1285075739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 N CAPEN AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893013",
            "telephone_number": "407-883-9303",
            "fax_number": "407-641-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 WOODWARD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034256",
            "telephone_number": "407-883-9303",
            "fax_number": "407-641-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PSYCHIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-894-6980",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005481100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.