Individual provider Active NPI

Yelaine Garcia Medina

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1336739812
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11030520 Issued in FL
Practice address
1317 NE 12TH PL
Cape Coral, FL 33909-1403
Phone
(305) 607-4304
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9470398 FL
Family Nurse Practitioner 363LF0000X 11030520 FL Primary

Addresses

Primary practice location

1317 NE 12TH PL
Cape Coral, FL 33909-1403

Mailing address

1317 NE 12TH PL
Cape Coral, FL 33909-1403
Phone (305) 607-4304

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240416004224 FL Practitioner - Nurse Practitioner 0749629210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cerebrum Healthcare LLCGroup PAC ID 8729341847, 19 clinicians

Practice addresses (Care Compare)

14305 Collier Blvd
Naples, FL 34119-9589
Phone (239) 383-6000

1730 NE Pine Island Rd
Encompass Health Rehabilitation Hospital of
Cape Coral, FL 33909-1734
Phone (239) 599-3600

2403 W Hillsboro Boulevard
Brookedale Deer Creek Alf
Deerfield Beach, FL 33442
Phone (954) 426-3800

37411 Eiland Blvd
Rosecastle of Zephyrhills
Zephyrhills, FL 33542-1800
Phone (813) 783-8100

5121 E Serena Dr
Palm Terrace Alf
Tampa, FL 33617-4012
Phone (813) 988-0033

6150 Medical Park Loop
Fort Myers, FL 33912-4537
Phone (239) 722-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9470398FLMDRegistered Nurse
11030520FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cerebrum Healthcare LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

3225 S Macdill Ave
Ste 129300
Tampa, FL 33629
Phone (813) 324-1911

3223 S Macdill Ave
Tampa, FL 33629

3225 S Macdill Ave
Tampa, FL 33629
Phone (813) 451-0013

Organizations & group practices 1

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": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1336739812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 NE 12TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339091403",
            "telephone_number": "305-607-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 NE 12TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339091403",
            "telephone_number": "305-607-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA MEDINA",
        "first_name": "YELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9470398",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11030520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.