Raul Ivan Medina Sicre, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

58428 Issued in AZ

Practice address

1940 W Indian School Rd Ste 1
Phoenix, AZ 85015-5112

Phone

(602) 782-1880

NPI assigned

Jun 27, 2014

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

Medicare fee-for-service enrollment

Enrolled in CA, AZ2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Street Health Physicians Group of Arizona PLLC 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Oak Street Health Physicians Group of Arizona PLLC

  • Primary Care Clinic/Center
  • Apache Junction, AZ
  • NPI 1063083590

  AZ, Family Medicine

  Medicare reassignment Care Compare group NPD
• Honorhealth Ambulatory

  • Hematology & Oncology Physician
  • Scottsdale, AZ
  • NPI 1407050917

  AZ

  Medicare reassignment NPD
• Honorhealth Medical Group, LLC

  • Primary Care Clinic/Center
  • Peoria, AZ
  • NPI 1043851793

  AZ

  Medicare reassignment NPD
• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622

  AZ, Family Medicine

  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  CA, Family Medicine

  Medicare reassignment NPD
• Honorhealth Ambulatory

  • Surgery Physician
  • Scottsdale, AZ
  • NPI 1457505828
  NPD
• Honorhealth Ambulatory

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1891518130
  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1184248411

  Family Medicine

  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1285338343

  Family Medicine

  NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Mount Sinai Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1871927053
  NPD (past)

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1649685652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746093",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746093",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W INDIAN SCHOOL RD STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155112",
            "telephone_number": "602-782-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6220 W Bell Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853083896",
            "country_code": "US",
            "telephone_number": "602-547-7300",
            "fax_number": "602-547-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA SICRE",
        "first_name": "RAUL",
        "middle_name": "IVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125064345",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "58428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medimin Inc
• Jazmin Leilany Medina Aispuro
• Roxana Ofelia Medina Estrada, NP
• Marilyn Medina Gonzalez
• Medina MD PC
• Luis Enrique Medina Torres, DMD, MS
• Julianna Medina Vazquez
• Alberto Segundo Medina, PA
• Andrew D Medina, LCSW
• Cory A Medina

• All providers in Phoenix, AZ
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.