EITAN MEDINI MD NPI 1962493643

NPI Information

NPI: 1962493643
Provider Name: EITAN MEDINI, MD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

PECOS Registration: Yes

Address:
1900 CENTRA CARE CIR #1600
CENTRA CARE CLINIC HEALTH PLAZA / RADIATION ONCOLOGY
ST CLOUD, MN
ZIP 56303
Phone: (320) 229-4901
Get Directions

Eitan Medini, MD is a radiation oncology radiology in St Cloud, MN. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. Eitan Medini, MD NPI is 1962493643. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1900 CENTRA CARE CIR #1600
CENTRA CARE CLINIC HEALTH PLAZA / RADIATION ONCOLOGY
ST CLOUD, MN
ZIP 56303-000
Phone: (320) 229-4901
Fax: (320) 229-5160

The NPI 1962493643 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/2/2005 and was last updated on 8/10/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0001X	Radiology	Radiation Oncology	21866	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	F55911	MEDICARE UPIN
2	920000210	MEDICARE PIN
3	1027482	OTHER		PREFERRED ONE
4	127789	OTHER		U CARE
5	HP33037	OTHER		HEALTH PARTNERS
6	COMP	OTHER		FIRST HEALTH PLAN
7	512RIME	OTHER		BLUE CROSS BLUE SHIELD
8	COMP	OTHER		ONE HEALTH PLAN GREAT WES
9	315JOME	OTHER		BLUE CROSS BLUE SHIELD
10	2400101	OTHER		MEDICA HEALTH PLANS
11	978660	OTHER		ARAZ GROUP AMERICAS PPO
12	COMP	OTHER		CHAMPUS
13	COMP	OTHER		MMSI
14	252563100	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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