Miles Anthony Medina, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

85502 Issued in GA

Practice address

1133 Eagles Landing Pkwy # ER
Stockbridge, GA 30281-5085

Phone

(678) 604-1000

NPI assigned

Mar 20, 2017

Sex

Male

Sole proprietor

No

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 GA

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

Specialty

Emergency Medicine

Education

West Virginia School of Osteopathic Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inphynet Primary Care Physicians Southeast PCGroup PAC ID 3779497045, 71 clinicians

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Sandy Creek Emergency Group, PCGroup PAC ID 3577905520, 44 clinicians

Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
• Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment Care Compare group NPD
• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460
  Medicare reassignment Care Compare group NPD
• Sandy Creek Emergency Group, PC

  • Emergency Medicine Physician
  • Fayetteville, GA
  • NPI 1427817881
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation
• Macon Northside Hospital, LLC

  dba Piedmont Macon North Hospital

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1811940976
  Care Compare affiliation
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1437690658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "678-604-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY # ER",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "678-604-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MILES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "85502",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med-South Primary Care
• Emily Caroline Medendorp, DMD
• Medex of Georgia Inc
• Medical Escort LLC
• Medicine Pointe Pharmacy LLC
• Medsure Supplies LLC
• Liliana Mejia, DDS
• Melapop Aesthetics LLC
• Geraldine Eccleston Menchion, FNP, BC
• Kenneth F. Menchion, MD

• Emergency Medicine Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.