Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Corina Medina

Individual provider Physical Therapist · NPI 1104687326

Corina Medina is a Physical Therapist in Private Practice in Lake Oswego, Oregon. Qualified in 2023, 3 years ago. Practices with Aegis Group Practice LLC, a 406-clinician group and accepts Medicare assignment. Licensed in New Mexico and Texas.

Years since qualifying
3
Licensed in
NM, TX
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

1200 Overlook Dr
Lake Oswego, OR 97034-6605
Phone: (503) 636-4589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1406420 (TX)
Physical Therapist Taxonomy 225100000X · Licence PT-2025-0054 (NM)

Record details

NPI number1104687326
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 16, 2024
Last updated in NPPESMay 12, 2025
Certification dateMay 12, 2025
Mailing address32715 Fm 1575, Los Fresnos, TX 78566-5068

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Aegis Group Practice Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Oswego