Individual provider Active NPI

Ana M. Medina

  • Marriage & Family Therapist
  • Palm Springs, FL
National Provider Identifier
1487901898
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMT 1748 Issued in FL
Practice address
2112 S Congress Ave
104
Palm Springs, FL 33406-7670
Phone
(561) 653-6292
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMT 1748 FL Primary

Addresses

Primary practice location

2112 S Congress Ave
104
Palm Springs, FL 33406-7670

Mailing address

2112 S Congress Ave
104
Palm Springs, FL 33406-7670
Phone (561) 653-6292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208000167 FL Practitioner - Marriage and Family Therapist 7416306048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marriage and Family Services IncGroup PAC ID 5294060984, 7 clinicians

Practice addresses (Care Compare)

15204 S Jog Rd
Suite 303
Delray Beach, FL 33446-2171
Phone (561) 503-3059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMT 1748FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marriage & Family Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Multicultural Community Mental Health Center Inc Past Accepting new patients

Locations

15204 S Jog Rd
Ste 303
Delray Beach, FL 33446
Phone (561) 503-3059

Organizations & group practices 2

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": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1487901898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 S CONGRESS AVE",
            "address_2": "104",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334067670",
            "telephone_number": "561-653-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 S CONGRESS AVE",
            "address_2": "104",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334067670",
            "telephone_number": "561-653-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANA",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT 1748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

Verify at the official NPI Registry.