Active NPI
Anisley Reyes Medina, APRN
- Family Nurse Practitioner
- Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11012359
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11012359 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intensive Care Experts Health Network LLC | Single Specialty | Current | Accepting new patients |
| Intensive Care Experts Health Network LLC | Single Specialty | Current | Accepting new patients |
| Energy Community Mental Health Clinic LLC | Single Specialty | Current | 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.
-
- Pulmonary Disease Physician
- Hallandale Beach, FL
- NPI 1164824397
Single Specialty
-
- Family Medicine Physician
- Miami, FL
- NPI 1295310514
Single Specialty
-
- Acute Care Nurse Practitioner
- Lawrenceburg, TN
- NPI 1184596637
Single Specialty
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.