Jaysa Medina, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-18-62812 Issued in FL

Practice address

1060 W Sr 434 Ste 108
Longwood, FL 32750-4953

Phone

(407) 324-7772

NPI assigned

Sep 21, 2022

Last updated

Sep 21, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Blue Path ABA

  dba Applied Behavior Center

  • Behavior Analyst
  • Longwood, FL
  • NPI 1891950671
  NPD

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1447973763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8530 MILANO DR APT 2132",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328102491",
            "telephone_number": "786-247-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W SR 434 STE 108",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504953",
            "telephone_number": "407-324-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JAYSA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-62812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medcare Services of Orlando, Inc. (Medcare Services)
• Medi Health
• Medicure Longwood Inc (medicure Longwood)
• Angela J Medina-Lago
• Diandra Medina
• Violeta Medina
• Amy Meinig
• Jorge Y Melendez Noriega, MA
• Melissa C Verde DPM PA
• Melissa Young and Associates

• Behavior Technician in Longwood, FL
• Providers in Longwood, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.