Individual provider Active NPI

Benjamin Louis Medina, CRNA

  • Certified Registered Nurse Anesthetist
  • Dayton, OH
National Provider Identifier
1043027352
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
152607 Issued in ME
Practice address
405 W Grand Ave
Dayton, OH 45405-7538
Phone
(937) 723-3200
NPI assigned
Dec 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 152607 ME Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-7538

Mailing address

4045 Brookdale LN Unit 7
Dayton, OH 45440-4186
Phone (207) 975-0076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210002158 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678003415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Anesthesia Management LLCGroup PAC ID 3476079591, 9 clinicians
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

1118 Fairington Dr
Sidney, OH 45365-8913
Phone (937) 492-3755

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
152607MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 10, 2025 Accepting new patients
Peak Anesthesia Management LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 4, 2025 Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

1118 Fairington Dr
Sidney, OH 45365
Phone (937) 492-3755

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1043027352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 BROOKDALE LN UNIT 7",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454404186",
            "telephone_number": "207-975-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454057538",
            "telephone_number": "937-723-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS MEDINA",
        "first_name": "BENJAMIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "152607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.