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JACQUELINE MEDINA
NPI 1003552522
Counselor - Mental Health in New York, NY

Active since May 08, 2022PECOS EnrolledAccepts Medicare Assignment
160 W 86TH ST, NEW YORK, NY 10024(212) 875-1300 Get Directions Write a Review

NPPES record last updated: May 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jacqueline Medina NPPES

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

JACQUELINE MEDINA (NPI 1003552522) is an individual mental health provider in New York, New York and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1003552522
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE MEDINA
Location Address160 W 86TH STNew York, NY 10024-4018
Mailing Address5272 72nd St Fl 1Maspeth, NY 11378-1436 · (347) 295-5181
Phone(212) 875-1300
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 8, 2022
NPPES CertifiedMay 8, 2022
✔ NPI 1003552522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
160 W 86TH ST, New York, NY 10024
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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 and accepts Medicare assignment

Jacqueline Medina is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698112555
PECOS Enrollment IDI20240327002045
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 Jacqueline Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Metropolitan Center For Mental Health, Inc.
Same address
Group Psychotherapy
160 W 86TH ST
New York, NY 10024
  • Reassigned Medicare billing, New York enrollment
  • 70 clinicians in this Medicare group
NPI 1275695371 (212) 362-8755

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.

DR. NESTOR IVAN BORRERO-BRACERO PH.D.
Psychologist
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 362-8755
HELENE GERAMIAN
Psychologist
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 362-8755
GABRIEL FLORES
Counselor (School)
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 875-1300
ALQUIORIL POLANCO
Social Worker
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 362-8755
CAROLINE BARRETT SLOANE MSW
Social Worker (Clinical)
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 362-8755
MS. SADE ARZU M.A., LMHC
Counselor (Mental Health)
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 362-8755
COLLEEN MURPHY SULLIVAN
Social Worker
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 362-8755
DANIEL SAMOST MA
Student in an Organized Health Care Education/Training Program
160 W 86TH ST
NEW YORK, NY 10024
New York County (212) 875-1300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Medina's NPI number?

The NPI number for Jacqueline Medina is 1003552522. It was assigned to this individual provider in the NPPES registry on May 8, 2022.

Where is Jacqueline Medina located?

Jacqueline Medina practices at 160 W 86th St, New York, NY 10024. The listed phone number is (212) 875-1300.

What is Jacqueline Medina's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jacqueline Medina enrolled in Medicare?

Yes. Jacqueline Medina is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jacqueline Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Medina reassigns Medicare benefits to Metropolitan Center For Mental Health, Inc. (New York, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Medina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Medina was last updated on May 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.