JAMILLE NICHOLE AYALA MEDINA (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104705177

JAMILLE NICHOLE AYALA MEDINA (CRNA) is a healthcare provider. based in Hialeah, Florida. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. APRN11035648 (FL). The NPI Number for JAMILLE NICHOLE AYALA MEDINA (CRNA) is 1104705177

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
JAMILLE NICHOLE AYALA MEDINA (CRNA)
NPI
1104705177
Phone
(305) 822-4107
Address
2140 W 68TH ST STE 300
Enumeration Date
2 September 2025
Last Update Date
2 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3058224107
Graduation Year
2019 (7 years ago)
PAC ID
0840794152
Group Practice PAC ID
7416028725
Professional Enrollment ID
I20250919000036
Address ID
FL330161815HI2140XSTXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

5,359 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL

Provider Addresses for JAMILLE NICHOLE AYALA MEDINA (CRNA)

  • 2140 W 68TH ST STE 300

    HIALEAH, FL 330161815

    Phone: (305) 822-4107

    Type: Mailing

  • 2140 W 68TH ST STE 102

    HIALEAH, FL 330161815

    Phone: (305) 822-4107

    Fax: (305) 822-5086

    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: 2025-09-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250919000036ICertified Registered Nurse Anesthetist (Crna)FLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 33016)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416028725View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)PR
Certified Registered Nurse Anesthetist (Crna)FL
-PR
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL

Reviews

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Frequently asked questions

What is JAMILLE NICHOLE AYALA MEDINA (CRNA)'s NPI number?
JAMILLE NICHOLE AYALA MEDINA (CRNA)'s NPI is 1104705177 — the number used across U.S. healthcare to identify this provider.
Would JAMILLE NICHOLE AYALA MEDINA (CRNA) appear as active to a payer?
You can treat JAMILLE NICHOLE AYALA MEDINA (CRNA) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe JAMILLE NICHOLE AYALA MEDINA (CRNA)'s focus?
For JAMILLE NICHOLE AYALA MEDINA (CRNA), the primary taxonomy reads as Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where in Florida is JAMILLE NICHOLE AYALA MEDINA (CRNA) registered?
Use Hialeah, Florida as the headline location for JAMILLE NICHOLE AYALA MEDINA (CRNA) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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