Patricia Medina

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1018205 Issued in TX

Practice address

2312 Western Trails Blvd Ste A102
Austin, TX 78745-1677

Phone

(512) 840-1273

Fax

(888) 326-4711

NPI assigned

Jan 23, 2020

Sex

Female

Sole proprietor

Yes

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

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: patricia.medina.1@16277.direct.athenahealth.com

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.

• Center for Health and Recovery

  • Specialist
  • Phoenix, AZ
  • NPI 1992816060
  NPD (past)

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1528698974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 BILL PRICE RD",
            "city": "DEL VALLE",
            "state": "TX",
            "postal_code": "786173630",
            "telephone_number": "512-854-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 WESTERN TRAILS BLVD STE A102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451677",
            "telephone_number": "512-840-1273",
            "fax_number": "888-326-4711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3614 Bill Price Rd",
            "address_purpose": "LOCATION",
            "city": "Del Valle",
            "state": "TX",
            "postal_code": "786173630",
            "country_code": "US",
            "telephone_number": "512-854-4193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "775428",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1018205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa C. Medina, LCDC
• Maranda Medina, LCSW
• Maria S Medina, APN WHNP
• Martha Juliana Medina
• Melinda Rebecca Medina, PA-C
• Ryne Juliet Medina
• Sarah Dale Medina
• Medisource Supply Inc
• Medley Swim Systems Inc
• Melody Medley-Keith, PT, DPT

• Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.