Individual provider Active NPI

Christopher Ariel Medina, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Fort Worth, TX
National Provider Identifier
1386904225
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
S4821 Issued in TX
Practice address
855 Montgomery St
Fort Worth, TX 76107-2553
Phone
(817) 735-2235
NPI assigned
May 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 283559 NY
Family Medicine Physician 207Q00000X S4821 TX
Family Medicine Physician 207Q00000X 283559 NY
Neuromusculoskeletal Medicine & OMM Physician 204D00000X S4821 TX Primary

Addresses

Primary practice location

855 Montgomery St
Fort Worth, TX 76107-2553

Mailing address

855 Montgomery St
Fort Worth, TX 76107-2553
Phone (817) 735-2235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200722003267 TX Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 0941593040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

855 Montgomery St
Fort Worth, TX 76107-2553
Phone (817) 735-5418

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
University of North Texas Health Science Center at Fort Worth Neuromusculoskeletal Medicine & Omm CurrentSince Sep 1, 2020 Accepting new patients
University of North Texas Health Science Center at Fort Worth Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
University of North Texas Health Science Center at Fort Worth Family Medicine Current Accepting new patients
University of North Texas Health Science Center at Fort Worth Current Accepting new patients
University of North Texas Health Science Center at Fort Worth Neuromusculoskeletal Medicine & Omm Past Accepting new patients

Locations

855 Montgomery St
#M
Fort Worth, TX 76107
Phone (817) 735-2235

855 Montgomery St
Fl 6
Fort Worth, TX 76107
Phone (817) 735-2235

3500 Camp Bowie Blvd
Ft Worth, TX 76107
Phone (817) 735-2000

855 Montgomery St
Ft Worth, TX 76107
Phone (817) 735-2334

Interoperability endpoints

  • Direct secure messaging: christopher.medina.p1@direct.unthsc.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1386904225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MONTGOMERY ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072553",
            "telephone_number": "817-735-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CHRISTOPHER",
        "middle_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "283559",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S4821",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "283559",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "S4821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.