Lina Pereira Medeiros

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

200032726 Issued in CA

Practice address

29316 Lake Mist Dr
Lake Elsinore, CA 92530-7274

Phone

(951) 348-0060

NPI assigned

Jan 23, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1912405192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29316 LAKE MIST DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29316 LAKE MIST DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307274",
            "telephone_number": "951-348-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "LINA",
        "middle_name": "PEREIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "200032726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912405192",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie L McDonald, SLPA
• Sheena McFadden
• Leslie McFarlane
• Latiffah Abdullah McGinness, MD FAAP MBBS
• Shelley L McRoberts, LVN
• Medical Supply Superstore Inc
• Daisy Medina
• Rudy Medina
• Xerona Meese
• Hans Christiaan Mendez, DPT

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.