Active NPI
Anita Medolla, APRN CRNA
- Certified Registered Nurse Anesthetist
- Palm Beach Gardens, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 11039849
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Practice addresses (Care Compare)
1210 S Old Dixie Hwy
Jupiter, FL 33458-7205
Phone (954) 939-5000
Hospital & facility affiliations
- Jupiter Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9460694 | FL | MD | Critical Care Medicine Registered Nurse |
| 11039849 | FL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jupiter Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Jupiter Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | Current | 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.
-
- Anesthesiology Physician
- Jupiter, FL
- NPI 1700073848
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Pensacola, FL
- NPI 1316330830
-
- Anesthesiology Physician
- Jupiter, FL
- NPI 1003581398
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jupiter, FL
- NPI 1295721090
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.