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SHAUN MEDINA MD
NPI 1427707850
Student in an Organized Health Care Education/Training Program in Bronx, NY

Active since March 22, 2022PECOS Enrolled
111 E 210TH ST, BRONX, NY 10467(718) 920-4321 Get Directions Write a Review

NPPES record last updated: March 22, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Shaun Medina Md NPPES

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

SHAUN MEDINA MD (NPI 1427707850) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Ohio State University College Of Medicine (2022).

NPPES Registry Identity

NPI1427707850
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHAUN MEDINACredential: MD
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address111 E 210th StBronx, NY 10467-2401
Phone(718) 920-4321
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2022
Enumeration DateMarch 22, 2022
NPPES CertifiedMarch 22, 2022
✔ NPI 1427707850 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.
111 E 210TH ST, Bronx, NY 10467
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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 (PECOS)

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

PECOS PAC ID2466910351
PECOS Enrollment IDI20260820003958
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 Shaun Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore - Lij Anesthesiology, PC
22 mi
Anesthesiology
480 BEDFORD RD BLDG B
Chappaqua, NY 10514
  • Reassigned Medicare billing, New York enrollment
  • 1,406 clinicians in this Medicare group
NPI 1417401266 (914) 666-8866

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.

HEATHER ROOT MD
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-8592
MICHAEL GOTTESMAN M.D.
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-5506
JIAE LEE M.D.
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
DR. MICHELLE DOMINIQUE PINTEA MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
TELISHA MCLEAN
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
SHIVADITYA CHOUDHURY
Anesthesiology
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
MS. JOHANNA SHEA-FEN TAN
Student in an Organized Health Care Education/Training Program
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
JACK DANIEL HALLIGAN MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321

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 Shaun Medina's NPI number?

The NPI number for Shaun Medina is 1427707850. It was assigned to this individual provider in the NPPES registry on March 22, 2022.

Where is Shaun Medina located?

Shaun Medina practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 920-4321.

What is Shaun Medina's specialty?

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

Is Shaun Medina enrolled in Medicare?

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

Which organization bills Medicare for Shaun Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shaun Medina reassigns Medicare benefits to North Shore - Lij Anesthesiology, PC (Chappaqua, 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 Shaun 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 Shaun Medina was last updated on March 22, 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.