Edward Robles Medina, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

227427 Issued in NY

Practice address

516 E. Nizhoni Blvd
Gallup, NM 87301-1337

Phone

(505) 722-1000

Fax

(505) 722-1421

NPI assigned

Jun 14, 2006

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 2

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

Anesthesiology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHHS PHS Naihs Chinle Comprehensive Health Care FacilityGroup PAC ID 9436062585, 160 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chinle Comprehensive Health Care Facility Hospital, Chinle, AZ, CCN 030084

Merit-based Incentive Payment System (MIPS)

Final score

80.86 of 100Reported as group

Quality

61.32

Improvement activities

40

Cost

90.46

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment Care Compare group NPD
• DHHS PHS Naihs Chinle Comprehensive

  • Ambulatory Surgical Clinic/Center
  • Chinle, AZ
  • NPI 1922253129
  NPD
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Rock Point, AZ
  • NPI 1154344133
  NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1619910080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E. NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EDWARD",
        "middle_name": "ROBLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "227427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01221787",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "759128",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Andrea McRae, RN
• Jacqueline Meade, RN
• Kara Mealer
• Tammy Lynn Mecale, RN
• Medicab LLC
• Tammy D Medley, RN
• Happy Megie
• Stephen Mehanni, M.D.
• Timothy Neal Meinhardt, PHARM.D
• Richard Michael Melanson, R.N.

• Anesthesiology Physician in Gallup, NM
• Providers in Gallup, NM by specialty
• Anesthesiology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.