Bayamon Podiatric Clinic PSC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

BAYAMON PODIATRIC CLINIC PSC

Practice address

P12 Calle Magnolia
Bayamon, PR 00956-2608

Phone

(787) 785-9282

NPI assigned

Mar 17, 2021

Last updated

Dec 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edmond Medina, DPMNPI 1275521312

Title

President

Phone

(787) 565-4886

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edmond Medina, MD

  • Podiatrist
  • Bayamon, PR
  • NPI 1275521312
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1306421714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P12 AVE MAGNOLIA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009562608",
            "telephone_number": "787-785-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "P12 CALLE MAGNOLIA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009562608",
            "telephone_number": "787-785-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYAMON PODIATRIC CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-565-4886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "7872000482",
            "affiliation": "N",
            "endpointDescription": "FAX",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "bayamon",
            "address_1": "P12 Calle Magnolia",
            "city": "Bayamon",
            "state": "PR",
            "country_code": "US",
            "postal_code": "009562608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bayamon Oncology Medical CSP
• Bayamon Optical Inc
• Bayamon Parcial
• Bayamon Pediatric and Adolescent Medicine Services,PSC
• Bayamon Pediatric Pulmonary Services
• Bayamon Prosthetics & Orthotics Inc
• Bayamon Radiology LLC
• Maribel Bayona Sastre, M.ED M.PSY.D
• Rebeca Bayron-Adames, MD, DABFM
• Merardo Antonio Becerra, MEDICAL DOCTOR

• Foot & Ankle Surgery Podiatrist in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Foot & Ankle Surgery Podiatrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.