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VICTOR JAVIER MEDINA MD
NPI 1417659160
Internal Medicine in Kewanee, IL

Active since March 20, 2023PECOS Enrolled
519 ELLIOTT ST STE S1, KEWANEE, IL 61443(309) 853-2442(309) 853-3640 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 26, 2026, Nov 14, 2025, Mar 20, 2023 (3 updates tracked since 2023).

About Victor Javier Medina Md NPPES

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

VICTOR JAVIER MEDINA MD (NPI 1417659160) is an individual internal medicine provider in Kewanee, Illinois, licensed in Illinois (036.177031) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1417659160
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameVICTOR JAVIER MEDINACredential: MD
Location Address519 ELLIOTT ST STE S1Kewanee, IL 61443-2776
Mailing Address519 Elliott St Ste S1Kewanee, IL 61443-2776 · (309) 853-2442 · Fax (309) 853-3640
Phone(309) 853-2442
Fax(309) 853-3640
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 20, 2023
Last NPPES UpdateMay 26, 20263 updates tracked since enumeration
NPPES CertifiedMay 26, 2026
✔ NPI 1417659160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036.177031
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 036.177031 (IL), A197207 (CA), ME1777341 (FL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
519 ELLIOTT ST STE S1, Kewanee, IL 61443
Open in Google Maps ↗

Secondary Practice Location 1

Location 1200 W Arbor Dr # Mc8425San Diego, CA 92103-1911 · Phone (619) 543-6268

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Victor Javier Medina Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698245108
PECOS Enrollment IDI20260526003331
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 Reassignments

2

Medicare enrollment records show Victor Medina reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ahearn & Associates Medical Center, Inc
0.1 mi
Rural Health
513 ELLIOTT ST, SUITE 4
Kewanee, IL 61443
  • Reassigned Medicare billing, Illinois enrollment
  • 7 clinicians in this Medicare group
NPI 1114036308 (309) 853-2442
Signify Health Medical Associates, PLLC
688 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Illinois enrollment
  • 712 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61443 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Other Providers at the Same Location NPPES

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

CARE CONNECT OF ILLINOIS PROVIDERS PLLC
Internal Medicine
519 ELLIOTT ST STE S1
KEWANEE, IL 61443
Henry County (309) 525-0703

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 Victor Medina's NPI number?

The NPI number for Victor Medina is 1417659160. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Where is Victor Medina located?

Victor Medina practices at 519 Elliott St Ste S1, Kewanee, IL 61443. The listed phone number is (309) 853-2442.

What is Victor Medina's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Victor Medina enrolled in Medicare?

Yes. Victor Medina is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Victor Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Victor Medina reassigns Medicare benefits to 2 organizations: Ahearn & Associates Medical Center, Inc (Kewanee, IL) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Victor 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 Victor Medina was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.