NPIMap

Individual provider Active NPI

Angel Antonio Medina-Bravo, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Roanoke, VA
National Provider Identifier
1932375722
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101249280 Issued in VA
Practice address
2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone
(540) 725-1226
NPI assigned
May 1, 2008
Last updated
Oct 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 233458 MA
Physical Medicine & Rehabilitation Physician 208100000X 0101249280 VA Primary

Addresses

Primary practice location

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Mailing address

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110519000595 VA Practitioner - Physical Medicine and Rehabilitation 8022294420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Puerto Rico School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1902 Grace St
Lynchburg, VA 24504-3524
Phone (434) 200-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Jun 6, 2011 Accepting new patients

Locations

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

1902 Grace St
Lynchburg, VA 24504
Phone (434) 200-5100

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1932375722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-725-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-BRAVO",
        "first_name": "ANGEL",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-01",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "233458",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101249280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.