Active NPI
Sharon Medina
- Social Worker
- Flushing, NY
National Provider Identifier
1568871291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 101694
- Practice address
- 140-13B Sanford Avenue
Flushing, NY 11355 - Phone
- (718) 358-8288
- NPI assigned
- Aug 6, 2014
- Sex
- Female
- 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 | 101694 | NY | Primary |
Addresses
Primary practice location
140-13B Sanford Avenue
Flushing, NY 11355
Mailing address
15617 71St Ave
Apt. 5D
Flushing, NY 11367-2246
Phone (347) 322-9558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221003001779 | NY | Practitioner - Clinical Social Worker | 7214313055 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101694 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rivia Medical PLLC | Current | Accepting new patients |
Locations
2 University Plz
Ste 100
Hackensack, NJ 07601
Phone (201) 744-7749
274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515542400000",
"number": "1568871291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15617 71ST AVE",
"address_2": "APT. 5D",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113672246",
"telephone_number": "347-322-9558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140-13B SANFORD AVENUE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11355",
"telephone_number": "718-358-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "SHARON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-06",
"last_updated": "2018-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "101694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.