Active NPI
Jaime Medina Medina, MSW, JD
- Social Worker
- Ponce, PR
National Provider Identifier
1538680558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3685
- Practice address
- Cii 32 Jardines del Caribe
FF33
Ponce, PR 00728-2609 - Phone
- (787) 290-0022
- Fax
- (787) 842-5342
- NPI assigned
- Jun 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3685 | PR | Primary |
Addresses
Primary practice location
Cii 32 Jardines del Caribe
FF33
Ponce, PR 00728-2609
Mailing address
Cii 32 Jardines del Caribe
FF33
Ponce, PR 00728-2609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3685 | Other | PR | SOCIAL WORK PERMANENT LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Juris Doctor
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3685 | PR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498694400000",
"number": "1538680558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CII 32 JARDINES DEL CARIBE",
"address_2": "FF33",
"city": "PONCE",
"state": "PR",
"postal_code": "007282609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CII 32 JARDINES DEL CARIBE",
"address_2": "FF33",
"city": "PONCE",
"state": "PR",
"postal_code": "007282609",
"telephone_number": "787-290-0022",
"fax_number": "787-842-5342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA MEDINA",
"first_name": "JAIME",
"credential": "MSW, JD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-29",
"last_updated": "2017-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PR",
"license": "3685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK PERMANENT LICENCE",
"identifier": "3685",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.