Individual provider Active NPI

Jessielynn Avila, DPT

  • Pediatric Physical Therapist
  • Hialeah, FL
National Provider Identifier
1679877849
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT26138 Issued in FL
Practice address
1550 W 84TH St
#58
Hialeah, FL 33014-3377
Phone
(305) 985-6122
Fax
(786) 545-7657
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X PT26138 FL
Pediatric Physical Therapist 2251P0200X PT26138 FL Primary

Addresses

Primary practice location

1550 W 84TH St
#58
Hialeah, FL 33014-3377

Mailing address

1550 W 84TH St
#58
Hialeah, FL 33014-3377
Phone (305) 985-6122

Other identifiers 1

IdentifierTypeStateIssuer
003271100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160517001448 FL Practitioner - Physical Therapist in Private Practice 3779872601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26138FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bett-ER Support & Service Inc CurrentSince Sep 12, 2025 Accepting new patients
Bett-ER Support & Service Inc PastSince Feb 1, 2024 Accepting new patients

Locations

10691 N Kendall Dr
Ste 304
Miami, FL 33176
Phone (305) 960-7900

Organizations & group practices 2

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": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1679877849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 W 84TH ST",
            "address_2": "#58",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143377",
            "telephone_number": "305-985-6122",
            "fax_number": "786-545-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W 84TH ST",
            "address_2": "#58",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143377",
            "telephone_number": "305-985-6122",
            "fax_number": "786-545-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "JESSIELYNN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": "PT26138",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT26138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003271100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.