JOSE MEDINA MD PC
NPI 1407047269
Clinic/Center - Multi-Specialty in Valdosta, GA
About Jose Medina Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOSE MEDINA MD PC (NPI 1407047269) is a healthcare organization registered as a multi-specialty in Valdosta, Georgia and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through January 18, 2027 and lists Jose Medina, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jose Medina Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Jose Medina MD PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D0933792
Jose Medina MD · Valdosta, GAFrequently 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 Jose Medina MD PC's NPI number?
The NPI number for Jose Medina MD PC is 1407047269. It was assigned to this organization in the NPPES registry on August 7, 2007.
Where is Jose Medina MD PC located?
Jose Medina MD PC is located at 3334 Greystone Way, Valdosta, GA 31605. The listed phone number is (229) 247-1667.
What is Jose Medina MD PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Jose Medina MD PC enrolled in Medicare?
Yes. Jose Medina MD PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jose Medina MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Jose Medina MD PC. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jose Medina MD PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D0933792) is associated with this NPI, valid through January 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Jose Medina MD PC accept?
Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Jose Medina MD PC 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.
When was this NPI record last updated?
The NPPES record for Jose Medina MD PC was last updated on June 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Jose Medina Md Pc · NPI 1407047269
Multi-Specialty organization in Valdosta, Georgia. Organization record, active in the CMS NPPES registry since August 7, 2007.
## Identity
- **NPI:** 1407047269 (Entity type: Organization)
- **Enumerated:** August 7, 2007
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Jose Medina, OWNER
## Practice location
- **Address:** 3334 GREYSTONE WAY, Valdosta, GA 31605-1096
- **Phone:** (229) 247-1667 · **Fax:** (229) 247-3456
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 15, 2010
- **Other identifiers:** Medicare PIN G17343 (GA); Medicare UPIN GRP4456 (GA); Medicaid 00686507C (GA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1407047269) · Data from the CMS NPPES public registry.