Individual provider Active NPI

Claudia M Medina, O.D.

  • Optometrist
  • McAllen, TX
National Provider Identifier
1790838969
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6617TG Issued in TX
Practice address
505 S Broadway St
McAllen, TX 78501-4903
Phone
(956) 682-2141
Fax
(956) 682-2142
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6617TG TX Primary

Addresses

Primary practice location

505 S Broadway St
McAllen, TX 78501-4903

Mailing address

505 S Broadway St
McAllen, TX 78501-4903
Phone (956) 682-2141

Other identifiers 1

IdentifierTypeStateIssuer
169533001MedicaidTX

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040913001356 TX Practitioner - Optometry 2466429030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Medina Vision Care PLLCGroup PAC ID 0244467082, 3 clinicians

Practice addresses (Care Compare)

2506 E Richardson Rd
Hammond Vision Center
Edinburg, TX 78542-0415
Phone (956) 720-4000

505 S Broadway St
McAllen, TX 78501-4903
Phone (956) 682-2141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6617TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medina Vision Care PLLC Optometrist CurrentSince Dec 1, 2013 Accepting new patients
Ana L Salinas Optometrist Past Accepting new patients
Emma E. Gonzalez OD PLLC Optometrist PastSince Apr 1, 2011 Accepting new patients

Locations

2506 E Richardson Rd
Edinburg, TX 78542
Phone (956) 655-0012

505 S Broadway St
McAllen, TX 78501
Phone (956) 682-2141

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1790838969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S BROADWAY ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785014903",
            "telephone_number": "956-682-2141",
            "fax_number": "956-682-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S BROADWAY ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785014903",
            "telephone_number": "956-682-2141",
            "fax_number": "956-682-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CLAUDIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6617TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169533001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.