Individual provider Active NPI

Marta Medina, MD

  • Psychiatry Physician
  • Humacao, PR
National Provider Identifier
1376672253
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
12517 Issued in PR
Practice address
Humacao Medical Plaza Ave. Font Martelo 53 Suite 203
Humacao, PR 00791
Phone
(787) 285-1270
Fax
(787) 285-1970
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 12517 PR Primary

Addresses

Primary practice location

Humacao Medical Plaza Ave. Font Martelo 53 Suite 203
Humacao, PR 00791

Mailing address

Humacao Medical Plaza Ave. Font Martelo 53 Suite 203
Humacao, PR 00791
Phone (787) 285-1270

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120612000321 PR Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 8628232246 Practice locations: Caguas, PR; Condado, PR; Humacao, PR

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Ponce School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Calle Munoz Rivera
Suite 313
Caguas, PR 00725-2604
Phone (787) 636-2850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1376672253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HUMACAO MEDICAL PLAZA AVE. FONT MARTELO 53 SUITE 203",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-285-1270",
            "fax_number": "787-285-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HUMACAO MEDICAL PLAZA AVE. FONT MARTELO 53 SUITE 203",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-285-1270",
            "fax_number": "787-285-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MARTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "12517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

Sources for this page

Verify at the official NPI Registry.