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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. MARISA MEDINA APRN
NPI 1891256517
Nurse Practitioner - Family in Channahon, IL

Active since March 26, 2019PECOS Enrolled
24735 W EAMES ST UNIT 10, CHANNAHON, IL 60410(815) 200-6993 Get Directions Write a Review

NPPES record last updated: October 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 16, 2026, Sep 8, 2021 (2 updates tracked since 2021).

About Mrs. Marisa Medina Aprn NPPES

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

MRS. MARISA MEDINA APRN (NPI 1891256517) is an individual family provider in Channahon, Illinois, licensed in Illinois (277001697) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891256517
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. MARISA MEDINACredential: APRN
Location Address24735 W EAMES ST UNIT 10Channahon, IL 60410-8712
Mailing Address24735 W Eames St Unit 10Channahon, IL 60410-8712 · (815) 200-6993
Phone(815) 200-6993
Sole ProprietorNo
Enumeration DateMarch 26, 2019
Last NPPES UpdateOctober 16, 20262 updates tracked since enumeration
NPPES CertifiedOctober 16, 2026
✔ NPI 1891256517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 277001697
24735 W EAMES ST UNIT 10, Channahon, IL 60410
Open in Google Maps ↗

Other Names 1

Former Name (1)Marisa Ruiz

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Marisa Medina Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Marisa Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Will County Community Health Center
8.7 mi
Federally Qualified Health Center (FQHC)
1106 NEAL AVE
Joliet, IL 60433
  • Reassigned Medicare billing, Illinois enrollment
  • 34 clinicians in this Medicare group
NPI 1902811714 (815) 727-8670

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 60410 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

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 Marisa Medina's NPI number?

The NPI number for Marisa Medina is 1891256517. It was assigned to this individual provider in the NPPES registry on March 26, 2019. The provider is also known as Marisa Ruiz.

Where is Marisa Medina located?

Marisa Medina practices at 24735 W Eames St Unit 10, Channahon, IL 60410. The listed phone number is (815) 200-6993.

What is Marisa Medina's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Marisa Medina enrolled in Medicare?

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

Which organization bills Medicare for Marisa Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marisa Medina reassigns Medicare benefits to Will County Community Health Center (Joliet, IL). 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 Marisa 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 Marisa Medina was last updated on October 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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.