Individual provider Active NPI

Jessica Medina

  • Physical Therapy Assistant
  • West Palm Beach, FL
National Provider Identifier
1558073502
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA30021 Issued in FL
Practice address
300 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2710
Phone
(561) 657-4600
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA30021 FL Primary

Addresses

Primary practice location

300 Palm Beach Lakes Blvd
West Palm Beach, FL 33401-2710

Mailing address

1616 16TH Ter
Palm Beach Gardens, FL 33418-3661

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jmedina312856@direct.HSS.edu Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Direct
FHIR URL https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach Orthopaedic Institute PA PastSince Mar 1, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jmedina312856@direct.hss.edu
  • FHIR API: https://api.platform.athenahealth.com/13081/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1558073502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 16TH TER",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012710",
            "telephone_number": "561-657-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA30021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmedina312856@direct.HSS.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "535 E 70th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100214823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.