Michelle Tatiana Medina

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

229032 Issued in LA

Practice address

6823 Saint Charles Ave BLDG 92
New Orleans, LA 70118-5665

Phone

(504) 314-2277

NPI assigned

Mar 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY

  Medicare reassignment

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1376293308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 MEMORIAL PARK DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70114",
            "telephone_number": "954-604-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6823 SAINT CHARLES AVE BLDG 92",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185665",
            "telephone_number": "504-314-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MICHELLE",
        "middle_name": "TATIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11017323",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "1376293308",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "229032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicine and Nephrology Clinic of New Orleans LLC
• Medicine Pro LLC
• Medicor Healthcare, Inc.
• Melissa Medina, MD, MPH, MS
• Michael Medina
• Mediscan Imaging Inc
• Brenda Donatto Medley, NP
• Bridgette Medley, R.N.
• Medrite Pharmacy
• Megan Faulkner McIntyre

• Psychiatric/Mental Health Nurse Practitioner in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.