Individual provider Active NPI

Edmundo Medina, PA-C

  • Neurology Physician
  • Emeryville, CA
National Provider Identifier
1851242028
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
67784 Issued in CA
Practice address
2100 Powell St Ste 400
Emeryville, CA 94608-1872
Phone
(888) 544-4244
NPI assigned
Feb 4, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 67784 CA Primary

Addresses

Primary practice location

2100 Powell St Ste 400
Emeryville, CA 94608-1872

Mailing address

1097 Santo Antonio Dr Apt 67
Colton, CA 92324-4113
Phone (888) 544-4244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260311004503 CA Practitioner - Physician Assistant 3870076474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Neurology PCGroup PAC ID 3971871500, 60 clinicians

Practice addresses (Care Compare)

800 S Main St
Corona, CA 92882-3420
Phone (951) 737-4343

Hospital & facility affiliations

  • Corona Regional Medical Center Hospital, Corona, CA, CCN 050329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67784CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Neurology PC Neurology CurrentSince Feb 18, 2026 Accepting new patients
Cep America - Neurology PC Neurology CurrentSince Feb 18, 2026 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1851242028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 SANTO ANTONIO DR APT 67",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244113",
            "telephone_number": "888-544-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081872",
            "telephone_number": "888-544-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "EDMUNDO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "67784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.