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DR. CARLOS A MEDINA MD
NPI 1639193923
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Miami, FL

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
1611 NW 12TH AVE, M851, MIAMI, FL 33101(305) 243-4029(305) 243-8470 Get Directions Write a Review

NPPES record last updated: September 29, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 29, 2021, Sep 16, 2021 (2 updates tracked since 2021).

About Dr. Carlos A Medina Md NPPES

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

DR. CARLOS A MEDINA MD (NPI 1639193923) is an individual urogynecology and reconstructive pelvic surgery provider in Miami, Florida, licensed in Florida (ME60360) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of Ponce School Of Medicine (1989).

NPPES Registry Identity

NPI1639193923
Entity TypeIndividualMale
Primary Taxonomy207VF0040X
Provider Legal NameDR. CARLOS A MEDINACredential: MD
Location Address1611 NW 12TH AVE, M851Miami, FL 33101-6960
Mailing Address1611 Nw 12th Ave, Box 016960 M851Miami, FL 33101-6960 · (305) 243-4029 · Fax (305) 243-8470
Phone(305) 243-4029
Fax(305) 243-8470
Sole ProprietorNo
Medical School CMSPonce School Of MedicineGraduated 1989
Enumeration DateJuly 27, 2006
Last NPPES UpdateSeptember 29, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2021
✔ NPI 1639193923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
License✔ Licensed in FL · ME60360
Definition
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License ME60360 (FL)
1611 NW 12TH AVE, Miami, FL 33101
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Other Identifiers 1

Medicaid3732894-00FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) 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. Carlos A Medina Md 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 ID2668598681
PECOS Enrollment IDI20100928000639
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 straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
39 services28 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.
30 services24 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
21 services20 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33101 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$75.86 typical visit price
range $18.99 – $150.24
Typical copayment $18.96 (range $4.74 – $37.56)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

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. ANA ELISA CAMPO MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1611 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33101
Miami-Dade County (305) 355-9105
DR. CARLA S LUPI MD
Obstetrics & Gynecology (Gynecology)
1611 NW 12TH AVE
MIAMI, FL 33101
Miami-Dade County (305) 243-4029
DR. SALIH Y YASIN MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
1611 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33101
Miami-Dade County (305) 243-4029
DR. STEVEN SEVUSH MD
Psychiatry & Neurology (Psychiatry)
1611 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33101
Miami-Dade County (305) 355-9105
DR. HILDA M PANTIN PHD
Psychologist (Clinical)
1611 NW 12TH AVE, M851
MIAMI, FL 33101
Miami-Dade County (305) 355-9105
DR. JANET KONEFAL PHD
Acupuncturist
1611 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33101
Miami-Dade County (305) 355-9105
DR. NAHIDA A CHAKHTOURA MD
Obstetrics & Gynecology
1611 NW 12TH AVE, BOX 016960 M851
MIAMI, FL 33101
Miami-Dade County (305) 243-7688
ARTHUR E BETANCOURT PSYD
Psychologist
1611 NW 12TH AVE
MIAMI, FL 33101
Miami-Dade County (305) 243-6837

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 Carlos Medina's NPI number?

The NPI number for Carlos Medina is 1639193923. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Carlos Medina located?

Carlos Medina practices at 1611 NW 12th Ave M851, Miami, FL 33101. The listed phone number is (305) 243-4029.

What is Carlos Medina's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

Is Carlos Medina enrolled in Medicare?

Yes. Carlos 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 Carlos Medina accept?

Health plans from AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and Oscar Health Maintenance Organization of Florida and 1 other insurer list Carlos 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 Carlos Medina affiliated with any hospitals?

According to CMS data, Carlos Medina is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Carlos Medina was last updated on September 29, 2021. 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.