Individual provider Active NPI

Karen L Medin, D.O.

  • Neurology Physician
  • Syracuse, NY
National Provider Identifier
1881837169
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
56586 Issued in CT
Practice address
90 Presidential Plaza
4TH Floor
Syracuse, NY 13202
Phone
(315) 464-4243
NPI assigned
Apr 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 56586 CT Primary

Addresses

Primary practice location

90 Presidential Plaza
4TH Floor
Syracuse, NY 13202

Mailing address

85 Seymour Street, Suite 815
Hartford Healthcare Medicare Group
Hartford, CT 06106
Phone (860) 972-3621

Other identifiers 1

IdentifierTypeStateIssuer
03913971​MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171108001382 CT Practitioner - Neurology 3072738707 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
56586CTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Neurology CurrentSince Sep 1, 2019 Accepting new patients
Hartford Hospital Neurology CurrentSince Dec 31, 2017 Accepting new patients
Hartford Hospital CurrentSince Dec 31, 2017 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Sep 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc Neurology CurrentSince Sep 11, 2017 Accepting new patients

Locations

85 Seymour St
Ste 815
Hartford, CT 06106
Phone (860) 972-3600

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

462 Queen St
Ste 201
Southington, CT 06489
Phone (860) 621-1896

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Organizations & group practices 5

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": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1881837169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR STREET, SUITE 815",
            "address_2": "HARTFORD HEALTHCARE MEDICARE GROUP",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-972-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PRESIDENTIAL PLAZA",
            "address_2": "4TH FLOOR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13202",
            "telephone_number": "315-464-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIN",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "56586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03913971​",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.