Medina Primary Care PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

Q6929 Issued in TX

Legal business name

MEDINA PRIMARY CARE PLLC

Practice address

4013 14TH St
401
Plano, TX 75074-7125

Phone

(972) 456-9292

Fax

(972) 456-9393

NPI assigned

Jan 6, 2017

Organization subpart

No

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

Authorized official

Name

Mir Majid Ali, MDNPI 1366458069

Title

Physican Owner

Phone

(972) 456-9292

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medina Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mir Majid Ali, MD

  • Family Medicine Physician
  • Plano, TX
  • NPI 1366458069
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1922544592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 14TH ST",
            "address_2": "401",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750747125",
            "telephone_number": "972-456-9292",
            "fax_number": "972-456-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 14TH ST",
            "address_2": "401",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750747125",
            "telephone_number": "972-456-9292",
            "fax_number": "972-456-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "MIR",
        "authorized_official_middle_name": "MAJID",
        "authorized_official_title_or_position": "PHYSICAN OWNER",
        "authorized_official_telephone_number": "972-456-9292",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "Q6929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368903601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medina Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medicineers LLC
• Medigence Health, Inc.
• Blanca Yessenia Medina Apaez
• Emily Ann Medina
• Grecia Medina
• Jacob Medina, PT, DPT
• Meditech Supplies LLC
• Medpro Pharmacy #2

• Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.