Edward Medina, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1115 Issued in CO

Practice address

1710 1St St
Alamosa, CO 81101-2302

Phone

(719) 589-3658

Fax

(719) 589-0997

NPI assigned

Oct 24, 2005

Last updated

Jul 13, 2026By 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

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley-Wide Health Systems, Inc.Group PAC ID 5991609067, shared by 27 NPIs, 42 clinicians

Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008
• San Luis Valley Health Conejos County Hospital Hospital, La Jara, CO, CCN 061308

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.medina.p1@direct.vwhs.nextgenshare.com

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.

• Southern Colorado Clinic PC

  • Clinic/Center
  • Pueblo, CO
  • NPI 1285613554
  Medicare reassignment Care Compare group
• Valley-Wide Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1790998953
  NPD
• Valley-Wide Health Systems, Inc.

  dba Rock Creek Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1205652047
  NPD
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)

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

• Lutheran Hospital Association of the San Luis Valley

  dba SLV Health Conejos County Hospital

  • Critical Access Hospital Clinic/Center
  • La Jara, CO
  • NPI 1194792762
  Care Compare affiliation
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558351460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 1ST ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012302",
            "telephone_number": "719-589-3658",
            "fax_number": "719-589-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 1ST ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012302",
            "telephone_number": "719-589-3658",
            "fax_number": "719-589-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EDWARD",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN HEALTH PLA",
            "identifier": "840706945169",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lee McGeown, RD
• Leslie Myra McKnight, AA
• Judy McNeilsmith
• Darcey K McQuiston, RDH
• Miranda Nicole McWilliams
• Jacqueline Francine Medina, CAC II
• Patricia Meek
• Eva Suzanne Mejia, DDS
• Jill Mellott, OT
• Katherine Meloan

• Physician Assistant in Alamosa, CO
• Providers in Alamosa, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.