Individual provider Active NPI

Jadzia Carina Pineda Medina

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1861030629
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
178 Maujer St Apt 4C
Brooklyn, NY 11206-1348
Phone
(347) 661-6543
NPI assigned
Dec 11, 2019
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

178 Maujer St Apt 4C
Brooklyn, NY 11206-1348

Mailing address

178 Maujer St Apt 4C
Brooklyn, NY 11206-1348
Phone (347) 661-6543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230310000639 PA Practitioner - Physician Assistant 6204209349 Reassigns benefits to 4 organizations
I20240612004375 NY Practitioner - Physician Assistant 6204209349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 29, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Apr 29, 2024 Accepting new patients
Abington Memorial Hospital CurrentSince Nov 1, 2025 Accepting new patients
Abington Memorial Hospital CurrentSince Nov 1, 2025 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

1235 Old York Rd
Ste 119
Abington, PA 19001
Phone (215) 481-4575

1235 Old York Rd
Ste G18
Abington, PA 19001
Phone (215) 481-4932

1245 Highland Ave
Ste 109
Abington, PA 19001
Phone (215) 481-3900

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jpinedamed@montefioredirect.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1861030629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 MAUJER ST APT 4C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112061348",
            "telephone_number": "347-661-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 MAUJER ST APT 4C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112061348",
            "telephone_number": "347-661-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA MEDINA",
        "first_name": "JADZIA",
        "middle_name": "CARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.