MS. JASMIN JELISSA MALLOY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1457893489

MS. JASMIN JELISSA MALLOY (CRNA) is a healthcare provider. based in Davie, Florida. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 209016078 (IL). The NPI Number for MS. JASMIN JELISSA MALLOY (CRNA) is 1457893489

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MS. JASMIN JELISSA MALLOY (CRNA)
NPI
1457893489
Phone
(954) 475-4400
Address
3476 S University Dr
Enumeration Date
8 November 2016
Last Update Date
18 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4043511745
Graduation Year
2017 (9 years ago)
PAC ID
2466723598
Group Practice PAC ID
3577457183
Professional Enrollment ID
I20240808004662
Address ID
GA303091281AT1968XNWXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness75
Years active:9State licenses:5Digital endpointsOther names

5,360 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL

Provider Addresses for MS. JASMIN JELISSA MALLOY (CRNA)

  • 3476 S University Dr

    Davie, FL 333282000

    Phone: (954) 475-4400

    Type: Location

  • 1011, Northwest 187th Avenue, Pembroke Pines, Broward County, Florida, 33029, United States

    PEMBROKE PINES, FL 330292913

    Phone: (954) 554-6902

    Type: Location

  • 3476 S UNIVERSITY DR

    DAVIE, FL 333282000

    Phone: (954) 475-4400

    Type: Location

  • 1968 PEACHTREE RD NW

    ATLANTA, GA 303091281

    Phone: (404) 605-3775

    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: 2024-08-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20170808000003ICertified Registered Nurse Anesthetist (Crna)ILTBD
I20220425001808ICertified Registered Nurse Anesthetist (Crna)FLTBD
I20240808004662ICertified Registered Nurse Anesthetist (Crna)GATBD

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 33328)

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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: 3577457183View full group profile
NameSpecialtyState
Anesthesiology AssistantGA
Anesthesiology AssistantFL
Anesthesiology AssistantGA
Anesthesiology, Interventional Pain Management, Pain ManagementGA
-FL
Anesthesiology AssistantFL
A N E S T H E S I O L O G YGA
Certified Registered Nurse Anesthetist (Crna)PA
Anesthesiology AssistantFL
-FL

Reviews

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Frequently asked questions

How do I look up MS. JASMIN JELISSA MALLOY (CRNA) by NPI?
Use NPI 1457893489 when you need to reference MS. JASMIN JELISSA MALLOY (CRNA) in forms, claims, or directories.
Does this profile mean MS. JASMIN JELISSA MALLOY (CRNA) is currently active?
Yes — MS. JASMIN JELISSA MALLOY (CRNA) appears active in the national provider directory.
What field does MS. JASMIN JELISSA MALLOY (CRNA) work in?
You can think of MS. JASMIN JELISSA MALLOY (CRNA) as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is MS. JASMIN JELISSA MALLOY (CRNA)'s primary listing?
We display Davie, Florida because that is what the record indicates for MS. JASMIN JELISSA MALLOY (CRNA).
How can I contact MS. JASMIN JELISSA MALLOY (CRNA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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