Medina Community Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDINA COMMUNITY CLINIC INC

Practice address

828 N Olden Ave Ste 2
Trenton, NJ 08638-4902

Phone

(609) 323-5159

NPI assigned

Oct 16, 2024

Organization subpart

No

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

Authorized official

Name

Mira Sadeghi, MPH

Title

Director of Operations

Phone

(609) 533-1918

Specialties & licenses 1

Addresses

Other names 1

• Medina Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abdul H Kazi, M.D.

  • Psychiatry Physician
  • West Trenton, NJ
  • NPI 1902837503
  Medicare reassignment Care Compare group NPD
• Chinwe Emerah, NP

  • Family Nurse Practitioner
  • Bronx, NY
  • NPI 1912485871

  NJ

  Medicare reassignment Care Compare group NPD
• Venkatesan Sounderarajan, APN

  • Family Nurse Practitioner
  • Edison, NJ
  • NPI 1336963925

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1750101309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 US HIGHWAY 1",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405922",
            "telephone_number": "609-533-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 N OLDEN AVE STE 2",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086384902",
            "telephone_number": "609-323-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA COMMUNITY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "SADEGHI",
        "authorized_official_first_name": "MIRA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "609-533-1918",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medina Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wilma Y. McPherson, DMD
• Tyshima Nachey McRae
• Brianne A Meade, LCSW
• Michael Peter Meade, LSW
• Edwing Gerardo Medina Carcamo, M.D.
• Medlink Pharmacy
• Laila Mednis
• Shahid B. Meer, MD
• Sally Megalla, PHARMD
• Rohan Mehra, DO

• Family Medicine Physician in Trenton, NJ
• Providers in Trenton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.