Individual provider Active NPI

Anita Medolla, APRN CRNA

  • Certified Registered Nurse Anesthetist
  • Palm Beach Gardens, FL
National Provider Identifier
1245829902
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11039849 Issued in FL
Practice address
9123 N Military TRL
Palm Beach Gardens, FL 33410-5990
Phone
(561) 622-9300
NPI assigned
Jan 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 11039849 FL Primary
Critical Care Medicine Registered Nurse 163WC0200X 9460694 FL

Addresses

Primary practice location

9123 N Military TRL
Palm Beach Gardens, FL 33410-5990

Mailing address

1429 SW Seahawk Way
Palm City, FL 34990-4249
Phone (631) 896-8816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618003987 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527579226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jupiter Anesthesia Associates LLCGroup PAC ID 0547348211, 91 clinicians

Practice addresses (Care Compare)

1210 S Old Dixie Hwy
Jupiter, FL 33458-7205
Phone (954) 939-5000

Hospital & facility affiliations

  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9460694FLMDCritical Care Medicine Registered Nurse
11039849FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients

Locations

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

Organizations & group practices 3

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 1

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": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1245829902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 SW SEAHAWK WAY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349904249",
            "telephone_number": "631-896-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 N MILITARY TRL",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334105990",
            "telephone_number": "561-622-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDOLLA",
        "first_name": "ANITA",
        "credential": "APRN CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11039849",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "9460694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.