Individual provider Active NPI

Natalie Jo Medina, M.D.

  • General Practice Physician
  • National City, CA
National Provider Identifier
1578932893
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A54817 Issued in CA
Practice address
502 Euclid Ave Ste 306
National City, CA 91950-8902
Phone
(619) 267-1168
Fax
(619) 267-6644
NPI assigned
Sep 16, 2015
Last updated
Sep 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A54817 CA Primary

Addresses

Primary practice location

502 Euclid Ave Ste 306
National City, CA 91950-8902

Mailing address

PO Box 1404
Bonita, CA 91908-1404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809003053 CA Practitioner - Internal MedicinePractitioner - General Practice 4587963590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

502 Euclid Ave
Suite 306
National City, CA 91950-8902
Phone (619) 267-1168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A54817CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Medina M D Inc PastSince Apr 8, 2017 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1578932893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1404",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919081404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 306",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919508902",
            "telephone_number": "619-267-1168",
            "fax_number": "619-267-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "NATALIE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A54817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.