Individual provider Active NPI

Edward Medina, FNP

  • Family Nurse Practitioner
  • Montrose, CO
National Provider Identifier
1538624432
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0994430 Issued in CO
Practice address
816 S 5TH St Ste B
Montrose, CO 81401-5765
Phone
(970) 249-3322
Fax
(970) 240-7976
NPI assigned
Feb 5, 2019
Last updated
Feb 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0994430 CO Primary

Addresses

Primary practice location

816 S 5TH St Ste B
Montrose, CO 81401-5765

Mailing address

300 S Nevada Ave
Montrose, CO 81401-4273
Phone (970) 249-7751

Other identifiers 1

IdentifierTypeStateIssuer
0994430OtherCOSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227002542 CO Practitioner - Nurse Practitioner 6608115191 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedar Point Health LLCGroup PAC ID 0143119586, 45 clinicians

Practice addresses (Care Compare)

816 S 5TH St
Montrose, CO 81401-5765
Phone (970) 240-4311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0994430COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Point Health LLC CurrentSince Apr 1, 2019 Accepting new patients

Locations

2454 Highway 6 and 50
Ste 104
Grand Junction, CO 81505
Phone (970) 644-9900

569 32 Rd
Ste 12
Grand Junction, CO 81504
Phone (970) 523-3544

2303 S Townsend Ave
Ste A
Montrose, CO 81401
Phone (970) 240-6136

300 S Nevada Ave
Montrose, CO 81401
Phone (970) 252-1020

3330 S Rio Grande Ave
Montrose, CO 81401
Phone (970) 240-7314

816 S 5th St
Montrose, CO 81401
Phone (970) 240-4311

816 S 5th St
Ste B
Montrose, CO 81401
Phone (970) 240-4311

Interoperability endpoints

  • Direct secure messaging: emedina@montrosemedicine.gwaydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1538624432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014273",
            "telephone_number": "970-249-7751",
            "fax_number": "970-249-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 S 5TH ST STE B",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015765",
            "telephone_number": "970-249-3322",
            "fax_number": "970-240-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0994430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0994430",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.