Desiree Medina, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1044759 Issued in TX

Practice address

1810 Murchison Dr Ste 200
El Paso, TX 79902-2906

Phone

(915) 613-5580

NPI assigned

Jun 23, 2021

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mosaic Infusion Solutions LLC

  • Infusion Therapy Clinic/Center
  • San Antonio, TX
  • NPI 1831794171
  NPD
• Mosaic Infusion Solutions LLC

  • Infusion Therapy Clinic/Center
  • Anchorage, AK
  • NPI 1255067591
  NPD
• Mosaic Infusion Solutions LLC

  • Infusion Therapy Clinic/Center
  • Centennial, CO
  • NPI 1467016907
  NPD (past)

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1386213361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12380 EDGEMERE BLVD STE 102",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MURCHISON DR STE 200",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799022906",
            "telephone_number": "915-613-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6011 Randolph Blvd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782335719",
            "country_code": "US",
            "telephone_number": "210-729-5371",
            "fax_number": "833-914-0579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7625A Mesa College Dr",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921115343",
            "country_code": "US",
            "telephone_number": "844-243-7833",
            "fax_number": "949-864-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "DESIREE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026622",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1044759",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1044759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medimount Clinic PLLC (Canyon Family Clinic)
• Rocio Elisa Medina Martinez
• Estela Marisa Medina-Ontiveros, PHARMD
• Andrianna Michelle Medina
• Christopher Medina, LVN
• Eliael Medina, MD
• Elizabeth Medina, MD
• Gabriela Medina
• Jacqueline Medina, PHARMD
• Jacquelyne Cisneros Medina, LCSW

• Family Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.