Christopher Carlos Medina, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

241815 Issued in NY

Practice address

5800 Heritage Landing Dr Ste C
East Syracuse, NY 13057-9378

Phone

(315) 445-2701

Fax

(315) 445-2847

NPI assigned

Nov 16, 2006

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Obstetrics/Gynecology

Education

State University of New York at Buffalo School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crouse Hospital Hospital, Syracuse, NY, CCN 330203

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmedina788368@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crouse Medical Practice, PLLC

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1922321934
  Medicare reassignment Care Compare group NPD
• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370

  Obstetrics & Gynecology

  Medicare reassignment NPD
• St. Peter's Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834
  Medicare reassignment NPD
• St. Peter's Hospital of the City of Albany

  dba St. Peter's Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357
  Medicare reassignment NPD
• Crouse Medical Practice PLLC

  • Physician Assistant
  • East Syracuse, NY
  • NPI 1386990638
  NPD
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  NPD
• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  NPD (past)

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

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  Care Compare affiliation

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1518030402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 HERITAGE LANDING DR STE C",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579378",
            "telephone_number": "315-445-2701",
            "fax_number": "315-445-2847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Patroon Creek Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122065015",
            "country_code": "US",
            "telephone_number": "518-445-4320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CHRISTOPHER",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "241815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03450039",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "400 Patroon Creek Blvd Ste 102",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122065015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Georgette Lynn McKean-Gerbin, PTA
• Paige Ann McMinn
• Lauren Margerie McNally, NP
• Marissa McNamara, DPT
• Medical Imaging Center LLP
• Sean Meehan, MSED
• Fehid Mehic
• Andrew Meier
• Renee S Melfi, MD
• Madhavi Menon, MD

• Obstetrics & Gynecology Physician in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.
• 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.