Individual provider Active NPI

Anisley Reyes Medina, APRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1508431271
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11012359 Issued in FL
Practice address
4995 NW 72ND Ave Ste 102
Miami, FL 33166-5643
Phone
(786) 360-3584
Fax
(786) 360-3867
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN11012359 FL Primary

Addresses

Primary practice location

4995 NW 72ND Ave Ste 102
Miami, FL 33166-5643

Mailing address

11321 SW 239TH St
Homestead, FL 33032-3121
Phone (786) 720-3100

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
I20240531000367 FL Practitioner - Nurse Practitioner 5092157305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Experts Health Network, LLCGroup PAC ID 6608195599, 99 clinicians

Practice addresses (Care Compare)

701 N Federal Hwy
Suite 601
Hallandale Beach, FL 33009-2449
Phone (954) 482-4747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11012359FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Experts Health Network LLC Single Specialty CurrentSince Mar 23, 2024 Accepting new patients
Intensive Care Experts Health Network LLC Single Specialty CurrentSince Mar 23, 2024 Accepting new patients
Energy Community Mental Health Clinic LLC Single Specialty CurrentSince Mar 20, 2025 Accepting new patients

Locations

701 N Federal Hwy
Ste 601
Hallandale Beach, FL 33009
Phone (954) 573-2195

1859 Van Buren St
Hollywood, FL 33020
Phone (954) 920-0900

4995 NW 72nd Ave
Ste 102
Miami, FL 33166
Phone (786) 227-2966

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.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1508431271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 SW 239TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330323121",
            "telephone_number": "786-720-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "786-360-3584",
            "fax_number": "786-360-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES MEDINA",
        "first_name": "ANISLEY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.