Edgar Samuel Medina, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

Q4634 Issued in TX

Practice address

401 E Sonterra Blvd Ste 375
San Antonio, TX 78258-4321

Phone

(210) 908-6337

Fax

(855) 999-3755

NPI assigned

Aug 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Psychiatry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edgarmedina@tdh.allscriptsdirect.net
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Medpsych Wellness PLLC

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1447889258
  Medicare reassignment NPD Authorized official
• Border Region MH Mr Community Center

  • Psychiatry Physician
  • Laredo, TX
  • NPI 1124060173
  Medicare reassignment NPD
• Burke Center

  • Psychiatry Physician
  • Lufkin, TX
  • NPI 1396792420
  Medicare reassignment NPD
• The Gulf Coast Center

  • Psychiatry Physician
  • League City, TX
  • NPI 1245285899
  Medicare reassignment NPD
• Zeitgeist Expressions Inc

  • Mental Health Counselor
  • San Antonio, TX
  • NPI 1336150101
  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Psychiatry

  NPD
• Burke Center

  • Developmental Disabilities Clinic/Center
  • Lufkin, TX
  • NPI 1164572772
  NPD (past)

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1598045981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19141 STONE OAK PKWY SUITE 104",
            "address_2": "PMB 217",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583367",
            "telephone_number": "210-908-6337",
            "fax_number": "855-999-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E SONTERRA BLVD STE 375",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584321",
            "telephone_number": "210-908-6337",
            "fax_number": "855-999-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EDGAR",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A117829",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q4634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3577181-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cintia Isabel Medina
• Cynthia Medina
• Daniella M Medina
• Desiree Marmolejo Medina, LPC
• Diana S Medina, LPC
• Edward A. Medina, MD
• Edward C Medina, IDMT
• Elvira Basanes Medina
• Ernest Medina Jr., PHARM.D.
• Ester Yvonne Medina I, RBT

• Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.