Richard P Medina, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

047920 Issued in NY

Practice address

3719 88TH St FL 1
Jackson Heights, NY 11372-7630

Phone

(718) 685-0031

Fax

(718) 685-0033

NPI assigned

May 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Richard P. Medina, DDS, LLC

  • Dentist
  • Jackson Heights, NY
  • NPI 1053586164
  NPD (past) Authorized official

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1356553275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 88TH ST FL 1",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727630",
            "telephone_number": "718-685-0031",
            "fax_number": "718-685-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 88TH ST FL 1",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727630",
            "telephone_number": "718-685-0031",
            "fax_number": "718-685-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "RICHARD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047920",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MD Consultation LCSW PC
• Medcourt Pharmacy, Inc.
• Medi City Pharmacy Inc.
• Melissa Medina, PTA
• Patricia Medina, PT
• Bella Mednik, D.P.M.
• Karine M Mednik, MD
• Enrique J Mehl, LMSW
• Jessica Meis, PT
• Ivan Mejia, PHARMD

• Dentist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.