EITAN MEDINI (NPI# 1962493643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962493643 |
| Entity Type | Individual |
| Full Name | EITAN MEDINI |
| Credential | MD |
| Practice Address |
1900 Centra Care Cir #1600 Centra Care Clinic Health Plaza / Radiation Oncology St Cloud MN 56303-5000 |
| Practice Telephone | 3202294901 |
| Practice Fax Number | 3202295160 |
| Mailing Telephone | 3202294901 |
| Mailing Fax Number | 3202295160 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2011-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
21866 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICA HEALTH PLANS | 2400101 | 01 | |
| BLUE CROSS BLUE SHIELD | 315JOME | 01 | |
| U CARE | 127789 | 01 | |
| ARAZ GROUP AMERICAS PPO | 978660 | 01 | |
| PREFERRED ONE | 1027482 | 01 | |
| MMSI | COMP | 01 | |
| BLUE CROSS BLUE SHIELD | 512RIME | 01 | |
| ONE HEALTH PLAN GREAT WES | COMP | 01 | |
| FIRST HEALTH PLAN | COMP | 01 | |
| MN | 252563100 | 05 | |
| CHAMPUS | COMP | 01 | |
| HEALTH PARTNERS | HP33037 | 01 |
| Street Address |
1900 CENTRA CARE CIR #1600 CENTRA CARE CLINIC HEALTH PLAZA / RADIATION ONCOLOGY |
| City | ST CLOUD |
| State | MN |
| Zip Code | 56303-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831535863 | Megan Gentry Hodges | Radiology | 1900 Centracare Circle #1600, Centracare Clinic Health Plaza Radiology/oncology, St Cloud, MN 56303-5000 | 2013-05-16 |
| 1124173919 | David M Pence | Radiology | 1900 Centracare Circle, St Cloud, MN 56303 | 2007-01-24 |
| 1720155336 | Nelson L Adamson | Radiology | 1900 Centracare Circle, Centracare Clinic Health Plaza Specialties, St Cloud, MN 56303-5000 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669031423 | Kai Jiang | Radiology | 617 4th St Sw Apt 3, Rochester, MN 55902-3286 | 2019-06-06 |
| 1508205311 | Somu Suppiah | Radiology | 6500 Excelsior Blvd Dept Of, St Louis Park, MN 55426 | 2013-06-14 |
| 1063858769 | Sumit Sean Sood | Radiology | 5160 Fairview Blvd Ste 1100, Wyoming, MN 55092-8050 | 2013-05-21 |
| 1679838403 | Richard Lee | Radiology | 701 Park Ave # G1, Minneapolis, MN 55415-1623 | 2012-07-09 |
| 1396909404 | James Lee Ecker | Radiology | 10448 Vera Cruz Dr N, Brooklyn Park, MN 55443-2555 | 2008-07-17 |
| 1275627820 | Xin Wang | Radiology | The Center for Prostate Cancer, 420 Delaware Street Se, Mayo Building, Fourth Floor, Minneapolis, MN 55455 | 2006-10-03 |
| 1295759009 | Gregory Evan Meyers | Radiology | 6950 France Ave S Ste 200, Edina, MN 55435-2025 | 2006-07-26 |
| 1770526188 | Nathan Earl Hilton | Radiology | 215 Ivy St, Brainerd, MN 56401-3000 | 2006-06-14 |
| 1124082136 | Janel A Cox | Radiology | 631 Goodrich Ave, Saint Paul, MN 55105-3522 | 2006-04-14 |
| 1952378044 | Ellen E Bellairs | Radiology | 1580 Beam Ave, Maplewood, MN 55109-1127 | 2006-03-07 |
| Find all providers with the same taxonomy | ||||
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| 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.