DR. NICOLE I MEDINA (PSYD) – Clinical Psychologist, NPI 1235488008
Clinical Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. NICOLE I MEDINA (PSYD)
PO BOX 1348
WEST JORDAN, UT 840848348
Phone: (801) 850-4382
Type: Mailing
934 S MAIN ST
LAYTON, UT 840417135
Phone: (801) 773-7060
Type: Location
3737 w 4100 S Suite 200
West Valley City, UT 84120
Phone: (888) 949-4864
Type: Location
8184 S Highland Dr Ste C-104
Sandy, UT 840936477
Phone: (385) 645-4357
Type: Location
8160 S Highland Dr Ste C104
Sandy, UT 84093
Phone: (801) 850-4382
Type: Location
5965 S 900 E STE 100
MURRAY, UT 841211850
Phone: (801) 872-5516
Type: Mailing
5965 S 900 E
MURRAY, UT 841211757
Phone: (801) 872-5516
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-08-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200820002747 | I | Clinical Psychologist | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84084)
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