Individual provider Active NPI

Rita Elizabeth Medina, M.D.

  • Infectious Disease Physician
  • Valdosta, GA
National Provider Identifier
1922419928
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
88496 Issued in GA
Practice address
2418 N Oak St Ste B2
Valdosta, GA 31602-2576
Phone
(229) 433-1838
Fax
(928) 814-9529
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 88496 GA Primary
Infectious Disease Physician 207RI0200X 036142211 IL
Infectious Disease Physician 207RI0200X 58329 AZ

Addresses

Primary practice location

2418 N Oak St Ste B2
Valdosta, GA 31602-2576

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 214-3531

Other names 1

  • Rita Elizabeth Medina Vega Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210915000499 GA Practitioner - Infectious Disease 7911278627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

2417 N Patterson St
Suite 230B
Valdosta, GA 31602-2512
Phone (229) 433-4310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SGMC Physician Network Inc CurrentSince Sep 1, 2021 Accepting new patients
SGMC Affiliated Services LLC Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

2418 N Oak St
Ste B2
Valdosta, GA 31602
Phone (229) 433-1838

312 Canna Dr
Valdosta, GA 31602
Phone (229) 241-8750

410 Northside Dr
Valdosta, GA 31602
Phone (229) 242-7368

415 Pendleton Pl
Valdosta, GA 31602
Phone (229) 242-6868

413 Pendleton Pl
Valdosta, GA 31602
Phone (229) 244-6968

2501 N Ashley St
Valdosta, GA 31602
Phone (229) 224-7368

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Interoperability endpoints

  • Direct secure messaging: rmedinavega66563@sgmc.gadirect.net
  • Direct secure messaging: rmedina27880@directhoustonmethodist.org

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1922419928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-214-3531",
            "fax_number": "928-814-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 N OAK ST STE B2",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022576",
            "telephone_number": "229-433-1838",
            "fax_number": "928-814-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "RITA",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "88496",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036142211",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "58329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RITA",
            "last_name": "MEDINA VEGA",
            "middle_name": "ELIZABETH",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.