Paula Medina Medina, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN257 Issued in FL

Practice address

515 W 6TH St
Jacksonville, FL 32206-4324

Phone

(904) 253-1070

Fax

(904) 253-1943

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Paula Medina Medina Professional name

Medicare fee-for-service enrollment

Enrolled in FL

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

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 and National Provider Directory roles.

• Florida Department of Health

  • Public Health or Welfare Agency
  • West Palm Beach, FL
  • NPI 1134189103
  Medicare reassignment NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Quincy, FL
  • NPI 1346446895
  NPD (past)
• Integrate Community Health System, Inc.

  • Community Health Clinic/Center
  • Rio Piedras, PR
  • NPI 1518189984
  NPD (past)
• Lba Medical Services Inc

  • General Practice Physician
  • San Juan, PR
  • NPI 1144224874
  NPD (past)
• Prestige Medical Group Ljcpsc

  • Anesthesiology Physician
  • San Juan, PR
  • NPI 1437332624
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1285851147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 S CONGRESS AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334454617",
            "telephone_number": "561-274-3100",
            "fax_number": "561-274-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W 6TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064324",
            "telephone_number": "904-253-1070",
            "fax_number": "904-253-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA MEDINA",
        "first_name": "PAULA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "PR",
            "license": "14,374",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14,374",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "MEDINA MEDINA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Medicor Homecare, Inc
• Medicussx Spine & Joint, LLC
• Medifirst-Medifast, Inc
• Stanislava Medigovik, DPT
• Medikon LLC
• Monica Medina-Dobbs, 390200000X
• Marcelle Medina-Smester
• Beth Ann Medina
• Daniela Medina
• Edgar C Medina

• General Practice Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.