Kelly Maria Medina

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9119158 Issued in FL

Practice address

2801 NE 213TH St Ste 1001
Aventura, FL 33180-1265

Phone

(305) 466-9111

Fax

(305) 466-9127

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Joseph Gauta MD PAGroup PAC ID 6406836832, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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

• Genesiscare USA of Florida LLC

  • Radiation Oncology Physician
  • Fort Myers, FL
  • NPI 1134109747
  Medicare reassignment Care Compare group NPD (past)
• Joseph Gauta MD PA

  dba Florida Bladder Institute

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Naples, FL
  • NPI 1740229665
  Medicare reassignment Care Compare group
• Genesiscare USA of Florida LLC

  dba David Schwartzwald, MD: Urology Care Specialists

  • Urology Physician
  • Boca Raton, FL
  • NPI 1649093709
  NPD
• Genesiscare USA of Florida LLC

  dba GD Urology

  • Urology Physician
  • Boca Raton, FL
  • NPI 1831568179
  NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1225738545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 SW 124TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NE 213TH ST STE 1001",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801265",
            "telephone_number": "305-466-9111",
            "fax_number": "305-466-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "KELLY",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9119158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Specialists and Wellness Center of South Florida, LLC
• Medicament LLC
• Medidrive, LLC
• Carlos Reydell Medina, MD
• Karen Y Medina
• Muriel Veronica Medina, LCSW
• Yanelys Medina, APRN
• Medsmart Wellness Centers Inc.
• Jean Meetze, L.C.S.W.
• Daniel S Meister, DDS

• Medical Physician Assistant in Aventura, FL
• Providers in Aventura, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.