Angel Rolando Medina, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

19939 Issued in PR

Practice address

53 Calle Meditacion
Mayaguez, PR 00680-4818

Phone

(787) 833-1360

NPI assigned

May 14, 2018

Last updated

May 14, 2018By the provider in NPPES

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1285124370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CALLE SANTA MARIA",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 CALLE MEDITACION",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006804818",
            "telephone_number": "787-833-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANGEL",
        "middle_name": "ROLANDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "19939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerardo J Medina Caban, MD
• Debbie Ann Medina Gonzalez, OPTHOMETRIC, O.D.
• Kimberly Medina Morales
• Angel Medina Torres
• Cesar A Medina-Diaz, PSY.D., M.A.
• Benjamin Medina, MD
• Erik G Medina, M.D.
• Mara Lee Medina
• Miguel Angel Medina, NURSE
• Patricia Medina, R.D. C.D.E.

• General Practice Physician in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.