Individual provider Active NPI

Medina Iljazi, FNP-S

  • Critical Care Medicine (Internal Medicine) Physician
  • Southington, CT
National Provider Identifier
1700780384
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
194920 Issued in CT
Practice address
48 Blossom Way
Southington, CT 06489-1879
Phone
(860) 620-4400
NPI assigned
Oct 6, 2026
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 194920 CT Primary

Addresses

Primary practice location

48 Blossom Way
Southington, CT 06489-1879

Mailing address

48 Blossom Way
Southington, CT 06489-1879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1700780384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 BLOSSOM WAY",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 BLOSSOM WAY",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891879",
            "telephone_number": "860-620-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILJAZI",
        "first_name": "MEDINA",
        "credential": "FNP-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "194920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.