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DR. EDWIN MEDINA M.D.
NPI 1356487201
Family Medicine in Malta, MT

Active since January 29, 2007PECOS EnrolledAccepts Medicare Assignment
830 S CENTRAL AVE, MALTA, MT 59538(406) 390-2596(406) 654-2571 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 18, 2023, Apr 15, 2022 (2 updates tracked since 2022).

About Dr. Edwin Medina M.d. NPPES

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

DR. EDWIN MEDINA M.D. (NPI 1356487201) is an individual family medicine provider in Malta, Montana, licensed in Montana (9635) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Billings Clinic, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1356487201
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. EDWIN MEDINACredential: M.D.
Location Address830 S CENTRAL AVEMalta, MT 59538
Mailing AddressPo Box 1235Malta, MT 59538-1235 · (406) 301-1063 · Fax (406) 654-2810
Phone(406) 390-2596
Fax(406) 654-2571
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateJanuary 29, 2007
Last NPPES UpdateJanuary 18, 20232 updates tracked since enumeration
NPPES CertifiedAugust 2, 2022
✔ NPI 1356487201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MT · 9635
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
830 S CENTRAL AVE, Malta, MT 59538
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Other Identifiers 3

Medicaid0028223MT
Other000092611MT · Blue Cross Blue Shield
Medicaid0720001MT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Edwin Medina M.d. 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 ID1254234420
PECOS Enrollment IDI20091109000510
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.

Areas of Expertise CMS Part B claims 4

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.

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.
515 services150 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
48 services48 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
36 services26 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
26 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Billings Clinic

Acute Care Hospitals · Billings, MT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270004
Location2800 10th Ave NBillings, MT 59101 · Yellowstone County
Emergency services Birthing friendly

Phillips County Hospital - Cah

Critical Access Hospitals · Malta, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271312
Location311 S 8th Ave EMalta, MT 59538 · Phillips County
Emergency services

Frances Mahon Deaconess Hospital

Critical Access Hospitals · Glasgow, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271316
Location621 3rd St SGlasgow, MT 59230 · Valley County
Emergency services

Northern Montana Hospital

Critical Access Hospitals · Havre, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271348
Location30 13th StHavre, MT 59501 · Hill County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59538 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.97 typical visit price
range $56.81 – $172.26
Typical copayment $21.99 (range $14.20 – $43.06)
Most-billed visit code 99203
Established Patient
$100.16 typical visit price
range $18.24 – $140.32
Typical copayment $25.04 (range $4.56 – $35.08)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier30 claims30 services$109.35 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$35.00 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers23 claims23 services$177.05 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Edwin Medina's NPI number?

The NPI number for Edwin Medina is 1356487201. It was assigned to this individual provider in the NPPES registry on January 29, 2007.

Where is Edwin Medina located?

Edwin Medina practices at 830 S Central Ave, Malta, MT 59538. The listed phone number is (406) 390-2596.

What is Edwin Medina's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Edwin Medina enrolled in Medicare?

Yes. Edwin 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.

What insurance does Edwin Medina accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and Providence Health Plan list Edwin Medina as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edwin Medina affiliated with any hospitals?

According to CMS data, Edwin Medina is affiliated with Billings Clinic, Phillips County Hospital - Cah, Frances Mahon Deaconess Hospital and Northern Montana Hospital.

When was this NPI record last updated?

The NPPES record for Edwin Medina was last updated on January 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.