ILIANA PAOLA MEDINA
NPI 1003384405
Social Worker in Bronx, NY

Q: What is Iliana Medina's NPI number?

The NPI number for Iliana Medina is 1003384405. It was assigned to this individual provider in the NPPES registry on November 5, 2018.

Q: What is Iliana Medina's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Iliana Medina was last updated on April 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 05, 2018PECOS Enrolled

579 COURTLANDT AVE, BRONX, NY 10451(718) 485-2100 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 30, 2024, Sep 3, 2020, Nov 5, 2018 (3 updates tracked since 2018).

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About Iliana Paola Medina NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILIANA PAOLA MEDINA (NPI 1003384405) is an individual social worker in Bronx, New York and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1003384405

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameILIANA PAOLA MEDINA

Location Address579 COURTLANDT AVEBronx, NY 10451-5013

Mailing Address579 Courtlandt AveBronx, NY 10451-5013 · (718) 485-2100

Phone(718) 485-2100

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateNovember 5, 2018

Last NPPES UpdateApril 30, 20243 updates tracked since enumeration

NPPES CertifiedApril 30, 2024

✔ NPI 1003384405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

579 COURTLANDT AVE, Bronx, NY 10451

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Iliana Paola Medina is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID749621787

PECOS Enrollment IDI20240508003011

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Iliana Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York Psychotherapy And Counseling Center

13 mi

Community/Behavioral Health

17620 148TH AVE
Jamaica, NY 11434

Reassigned Medicare billing, New York enrollment
249 clinicians in this Medicare group

NPI 1902811342 (718) 553-1100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELVIN OLIVO

Counselor (Mental Health)