Kayla Elyse Medina, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95009728 Issued in CA

Practice address

1140 Sonoma Ave Ste 3
Santa Rosa, CA 95405-4817

Phone

(707) 527-7656

Fax

(707) 527-5015

NPI assigned

Dec 17, 2018

Last updated

Sep 30, 2024By 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

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

University of California, Davis School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Merit-based Incentive Payment System (MIPS)

Final score

96.26 of 100Reported as apm

Quality

84.3

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kayla.medina.p1@direct.cmcentersinc.nextgenshare.com
• Direct secure messaging: kmedina3530899@oc.providencedirect.org
• Direct secure messaging: kmedina554781@hisp.ehr.sutterhealth.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Planned Parenthood Shasta Diablo Inc

  • Community Health Clinic/Center
  • Concord, CA
  • NPI 1982763090
  Medicare reassignment NPD
• Planned Parenthood Shasta Diablo Inc

  dba Planned Parenthood Northern California

  • Clinical Medical Laboratory
  • San Rafael, CA
  • NPI 1750435244
  NPD
• Planned Parenthood Shasta Diablo, Inc.

  dba Planned Parenthood Northern California

  • Community Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1659671600
  NPD
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1770054678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 SONOMA AVE STE 3",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054817",
            "telephone_number": "707-527-7656",
            "fax_number": "707-527-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SONOMA AVE STE 3",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054817",
            "telephone_number": "707-527-7656",
            "fax_number": "707-527-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "KAYLA",
        "middle_name": "ELYSE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Support Los Angeles a Medical Corporation
• Medina & Oliva Dental PC (Cascade Family Dental)
• Cesar Ulyces Medina, PT
• Edgar Medina
• Ivan Medina
• Michael L. Medvin, M.D.
• Avery Meek
• Stephen Meffert, M.D.
• Mehdipour DMD PC
• Navid Mehdipour

• Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.

Verify at the official NPI Registry.