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MR. LUIS AUGUSTO MEDINA MORA M.D.
NPI 1164086369
Student in an Organized Health Care Education/Training Program in Jamaica, NY

Active since April 24, 2019PECOS Enrolled
82-68 164TH STREET, JAMAICA, NY 11432(718) 883-3000 Get Directions Write a Review

NPPES record last updated: February 5, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 3, 2026, Feb 5, 2020, Apr 24, 2019 (3 updates tracked since 2019).

About Mr. Luis Augusto Medina Mora M.d. NPPES

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

MR. LUIS AUGUSTO MEDINA MORA M.D. (NPI 1164086369) is an individual student in an organized health care education/training program in Jamaica, New York and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Lenox Hill Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1164086369
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. LUIS AUGUSTO MEDINA MORACredential: M.D.
Location Address82-68 164TH STREETJamaica, NY 11432
Mailing Address82-68 164th StreetJamaica, NY 11432 · (718) 883-3000
Phone(718) 883-3000
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateApril 24, 2019
Last NPPES UpdateFebruary 5, 20203 updates tracked since enumeration
✔ NPI 1164086369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
82-68 164TH STREET, Jamaica, NY 11432
Open in Google Maps ↗

Secondary Practice Locations 3

Location 124 Antrim Commons DrGreencastle, PA 17225-1623 · Phone (717) 217-6820 · Fax (717) 217-6942
Location 2601 E Main StWaynesboro, PA 17268-2332 · Phone (717) 217-6820 · Fax (717) 217-6942
Location 382-68 164th StreetJamaica, NY 11432 · Phone (718) 883-3000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Luis Augusto Medina Mora M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3274078787
PECOS Enrollment IDI20240709002273
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 Luis Medina Mora reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wellspan Medical Group
124 mi
Primary Care
30 W SWARTZVILLE RD
Reinholds, PA 17569
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 3,080 clinicians in this Medicare group
NPI 1629528211 (717) 484-4347

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

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
32 services28 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
31 services29 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
26 services21 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
25 services24 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
20 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lenox Hill Hospital

Acute Care Hospitals · New York, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330119
Location100 East 77th StreetNew York, NY 10021 · New York County
Emergency services Birthing friendly

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. NAFEA ALI M.D.
Internal Medicine (Geriatric Medicine)
82-68 164TH STREET, QUEENS HOSPITAL CENTER
QUEENS, NY 11432
Queens County (718) 883-4050
ANA LUCIA ALVITES P.A.-C
Physician Assistant
82-68 164TH STREET
JAMAICA, NY 11432
Queens County (718) 883-3000
EVAN SALVATI
Radiology (Diagnostic Radiology)
82-68 164TH STREET, QUEENS HOSPITAL CENTER
JAMAICA, NY 11432
Queens County (718) 883-3591
FNU SHAZNA MD
Student in an Organized Health Care Education/Training Program
82-68 164TH STREET, N BUILDING 7TH FLOOR, ROOM N705
JAMAICA, NY 11432
Queens County (718) 883-4583
MARIANELA FERNANDEZ
Physician Assistant
82-68 164TH STREET, SUITE 1B-02
JAMAICA, NY 11432
Queens County (718) 883-3070
LEONARD SMITH PA-C
Physician Assistant
82-68 164TH STREET
QUEENS, NY 11432
Queens County (718) 883-4640
RIFFAT E TASNIM RAHIE M.D.
Student in an Organized Health Care Education/Training Program
82-68 164TH STREET, RM N705
JAMAICA, NY 11432
Queens County (718) 883-4583
DHANDEVI PERSAND DO
Student in an Organized Health Care Education/Training Program
82-68 164TH STREET, N BUILDING, 7TH FLOOR, ROOM N705
JAMAICA, NY 11432
Queens County (718) 883-4583

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 Luis Medina Mora's NPI number?

The NPI number for Luis Medina Mora is 1164086369. It was assigned to this individual provider in the NPPES registry on April 24, 2019.

Where is Luis Medina Mora located?

Luis Medina Mora practices at 82-68 164th Street, Jamaica, NY 11432. The listed phone number is (718) 883-3000.

What is Luis Medina Mora's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Luis Medina Mora enrolled in Medicare?

Yes. Luis Medina Mora is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Luis Medina Mora's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Luis Medina Mora reassigns Medicare benefits to Wellspan Medical Group (Reinholds, PA). 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 Luis Medina Mora's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Luis Medina Mora affiliated with any hospitals?

According to CMS data, Luis Medina Mora is affiliated with Lenox Hill Hospital.

When was this NPI record last updated?

The NPPES record for Luis Medina Mora was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.