JORGE MEDINA (NPI# 1194762054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194762054 |
| Entity Type | Individual |
| Full Name | JORGE MEDINA |
| Credential | MD |
| Practice Address |
11161 Randolph Street Crown Point IN 46307-8564 |
| Mailing Address |
1040 Sierra Dr Suite 400 Greenwood IN 46143-7241 |
| Practice Telephone | 2196629424 |
| Practice Fax Number | 2196627465 |
| Mailing Telephone | 3175284284 |
| Mailing Fax Number | 3178658355 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2013-05-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01061849A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200825470 | 05 | |
| IN | ANTHEM TRADITIONAL | 000000722508 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205379674 | Jorge Arturo Medina Jr. | Nurse Practitioner | 6070 Gateway Blvd E Ste 506, El Paso, TX 79905-2031 | 2016-12-02 |
| 1477520930 | Jorge M Medina | Radiology | 55 Lake Ave N # S2-824, Worcester, MA 01655-0002 | 2006-03-03 |
| 1902367238 | Jorge Medina | Community Health Worker | 3180 Center St Ne, Salem, OR 97301-4532 | 2019-03-28 |
| 1518485804 | Jorge Ramos Medina | Occupational Therapy Assistant | 2320 Borst Ave, Centralia, WA 98531-1410 | 2017-09-07 |
| Street Address |
11161 RANDOLPH STREET |
| City | CROWN POINT |
| State | IN |
| Zip Code | 46307-8564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117935 | Alimat O Biokoro | Home Health Aide | 1446 W 94th Ct., Crown Point, IN 46307 | 2020-09-06 |
| 1508489931 | Gentle Hearts Cardiovascular Institution LLC | Internal Medicine | 5221 W Lincoln Hwy, Suite 1a, Crown Point, IN 46307 | 2020-05-20 |
| 1659933646 | Darshak Joshi | Physical Therapist | 860 Stillwater Parkway, Crown Point, IN 46307 | 2019-07-01 |
| 1215592001 | Jamie Monday | Counselor | 1416 East Joliet St., Crown Point, IN 46307 | 2019-05-07 |
| 1790281152 | Tempus Labs Inc. | Clinical Medical Laboratory | 9800 Connecticut Drive, Suite A2-100, Crown Point, IN 46307 | 2018-04-04 |
| 1669991170 | Katie Lynn Eich | Counselor | 1308 N. Main St, Crown Point, IN 46307 | 2017-09-15 |
| 1053847251 | Nicole Bashan Lewis | Counselor | 1325 W 98th Ave, Crown Point, IN 46307 | 2017-05-08 |
| 1710433008 | Paul Alvin Clavecilla | Physical Therapist | 1099 South Main St., Apt. 314, Crown Point, IN 46307 | 2016-08-28 |
| 1851761365 | Cynthia Catherine Grass Black | Social Worker | 8592 Bell Lane, Crown Point, IN 46307 | 2015-09-28 |
| 1326437799 | Ameya Dorsatwar | Physical Therapist | 1516 North Main St, Crown Point, IN 46307 | 2015-01-22 |
| Find all providers in zip 46307 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336692573 | Maria Mohammed Fariduddin | Internal Medicine | 1611 Fir Ave, Crown Point, IN 46307-9462 | 2016-07-24 |
| 1336566538 | Thanzeela Kausar Mohideen | Internal Medicine | 10215 Broadway, Crown Point, IN 46307-8001 | 2014-03-25 |
| 1467794883 | Ragini Bielski | Internal Medicine | 10215 Broadway Ste 205, Crown Point, IN 46307-8001 | 2013-03-24 |
| 1295991008 | Advanced Medical Centers, LLC | Internal Medicine | 1105 W 163rd Ave, Crown Point, IN 46307-9233 | 2008-07-31 |
| 1528228301 | Elite Internal Medicine PC | Internal Medicine | 1242 Surrey Ct, Crown Point, IN 46307-5239 | 2008-06-14 |
| 1134143019 | Erin Vicari | Internal Medicine | 213 S Court St, Suite B, Crown Point, IN 46307-3990 | 2006-07-26 |
| 1467416990 | Julia K Leblanc | Internal Medicine | 297 W Franciscan Dr Ste 203, Crown Point, IN 46307-4859 | 2006-04-13 |
| 1659342079 | Raul G Enad | Internal Medicine | 1201 S. Main St, Crown Point, IN 46307-8481 | 2006-02-01 |
| 1154308575 | Steven L Posar | Internal Medicine | 2100 N Main St Ste 304, Crown Point, IN 46307-1877 | 2005-12-28 |
| 1588669188 | Alison Petrovich | Internal Medicine | 11161 Randolph St, Crown Point, IN 46307-8564 | 2005-06-20 |
| Find all providers in CROWN POINT | ||||
| City | CROWN POINT |
| Zip Code | 46307 |
Please comment or provide details below to improve the information on JORGE MEDINA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.