MRS. KAYLA ELYSE MEDINA NP
NPI 1770054678
Nurse Practitioner in Santa Rosa, CA

Q: What is Kayla Medina's NPI number?

The NPI number for Kayla Medina is 1770054678. It was assigned to this individual provider in the NPPES registry on December 17, 2018.

Q: What is Kayla Medina's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kayla Medina was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 17, 2018PECOS EnrolledAccepts Medicare Assignment

1140 SONOMA AVE STE 3, SANTA ROSA, CA 95405(707) 527-7656(707) 527-5015 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 30, 2024, Jan 13, 2022, Sep 28, 2020 and 2 more (5 updates tracked since 2018).

On this page

About Mrs. Kayla Elyse Medina Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KAYLA ELYSE MEDINA NP (NPI 1770054678) is an individual nurse practitioner in Santa Rosa, California, licensed in California (95009728) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (2018).

NPPES Registry Identity

NPI1770054678

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. KAYLA ELYSE MEDINACredential: NP

Location Address1140 SONOMA AVE STE 3Santa Rosa, CA 95405-4817

Mailing Address1140 Sonoma Ave Ste 3Santa Rosa, CA 95405-4817 · (707) 527-7656 · Fax (707) 527-5015

Phone(707) 527-7656

Fax(707) 527-5015

Sole ProprietorNo

Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 2018

Enumeration DateDecember 17, 2018

Last NPPES UpdateSeptember 30, 20245 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2024

✔ NPI 1770054678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95009728

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1140 SONOMA AVE STE 3, Santa Rosa, CA 95405

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Kayla Elyse Medina Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133461536

PECOS Enrollment IDI20190506001253

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kayla Medina reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Planned Parenthood Shasta Diablo, Inc.

Same address

Community Health

1140 SONOMA AVE
Santa Rosa, CA 95405

Reassigned Medicare billing, California enrollment
61 clinicians in this Medicare group

NPI 1659671600 (707) 527-7656

Providence Medical Foundation

0.2 mi

Internal Medicine

500 DOYLE PARK DR, SUITE 303
Santa Rosa, CA 95405

Reassigned Medicare billing, California enrollment
1,699 clinicians in this Medicare group

NPI 1740584473 (707) 303-8300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. GWENDOLYN R RIDDELL CNM, APN

Midwife

1140 SONOMA AVE STE 3
SANTA ROSA, CA 95405

Sonoma County (707) 766-4276

LINDSEY MAE RICE RN

Registered Nurse (Women's Health Care, Ambulatory)

1140 SONOMA AVE STE 3
SANTA ROSA, CA 95405

Sonoma County (707) 527-7656

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kayla Medina's NPI number?

The NPI number for Kayla Medina is 1770054678. It was assigned to this individual provider in the NPPES registry on December 17, 2018.

Where is Kayla Medina located?

Kayla Medina practices at 1140 Sonoma Ave Ste 3, Santa Rosa, CA 95405. The listed phone number is (707) 527-7656.

What is Kayla Medina's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kayla Medina enrolled in Medicare?

Yes. Kayla Medina is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kayla Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kayla Medina reassigns Medicare benefits to 2 organizations: Planned Parenthood Shasta Diablo, Inc. (Santa Rosa, CA) and Providence Medical Foundation (Santa Rosa, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kayla Medina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kayla Medina was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.