JACQUELYN MEDINA DO
NPI 1780143628
Dermatology in Jacksonville Beach, FL

Q: What is Jacquelyn Medina's NPI number?

The NPI number for Jacquelyn Medina is 1780143628. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Q: What is Jacquelyn Medina's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacquelyn Medina was last updated on July 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 March 19, 2019PECOS EnrolledAccepts Medicare Assignment

1361 13TH AVE S STE 180, JACKSONVILLE BEACH, FL 32250(904) 247-4300 Get Directions Write a Review

NPPES record last updated: July 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 3, 2023, Mar 19, 2019 (2 updates tracked since 2019).

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About Jacquelyn Medina Do NPPES

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

JACQUELYN MEDINA DO (NPI 1780143628) is an individual dermatology provider in Jacksonville Beach, Florida, licensed in Florida (OS19989) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Orange Park, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1780143628

Entity TypeIndividualFemale

Primary Taxonomy207N00000X

Provider Legal NameJACQUELYN MEDINACredential: DO

Location Address1361 13TH AVE S STE 180Jacksonville Beach, FL 32250-3235

Mailing Address2001 Kingsley AveOrange Park, FL 32073-5148 · (904) 639-2000 · Fax (904) 639-2015

Phone(904) 247-4300

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMarch 19, 2019

Last NPPES UpdateJuly 3, 20232 updates tracked since enumeration

NPPES CertifiedJuly 3, 2023

✔ NPI 1780143628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in FL · OS19989

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1361 13TH AVE S STE 180, Jacksonville Beach, FL 32250

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Secondary Practice Location 1

Location 12001 Kingsley AveOrange Park, FL 32073-5148 · Phone (904) 639-2000 · Fax (904) 639-2015

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed, Cigna Healthcare and more.Insurance ›

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

Jacquelyn Medina Do 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 ID1153658133

PECOS Enrollment IDI20230718003140

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 Reassignment

Medicare enrollment records show Jacquelyn Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Aqua Dermatology Of Florida, PA

250 mi

Dermatology

900 VILLAGE SQUARE XING STE 210
Palm Beach Gardens, FL 33410

Reassigned Medicare billing, Florida enrollment
159 clinicians in this Medicare group

NPI 1538270335 (239) 313-2515

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

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

2,839 services513 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

1,536 services1,034 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

1,041 services728 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

737 services561 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

290 services233 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

250 services159 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

177 services177 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

164 services146 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

146 services132 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

112 services94 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

92 services79 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

57 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

53 services53 patients

Biopsy of ear 69100

A biopsy of the ear is a medical procedure where a small sample of tissue is taken from your ear for examination. This helps doctors diagnose any abnormalities or diseases. It's a simple process, usually done under local anesthesia, and has minimal risks.

45 services42 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm 11603

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

34 services31 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

33 services32 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

24 services22 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

23 services23 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32250 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

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 3

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

LINDSAY VINES APRN

Nurse Practitioner

1361 13TH AVE S STE 180
JACKSONVILLE BEACH, FL 32250

Duval County (850) 247-4300

DERMATOLOGY GROUP OF FLORIDA PA

Dermatology

1361 13TH AVE S STE 180
JACKSONVILLE BEACH, FL 32250

Duval County (904) 247-4300

MRS. CHRISTINE SIEW-PUN NG MD

Dermatology

1361 13TH AVE S STE 180
JACKSONVILLE BEACH, FL 32250

Duval County (904) 247-4300

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 Jacquelyn Medina's NPI number?

The NPI number for Jacquelyn Medina is 1780143628. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Where is Jacquelyn Medina located?

Jacquelyn Medina practices at 1361 13th Ave S Ste 180, Jacksonville Beach, FL 32250. The listed phone number is (904) 247-4300.

What is Jacquelyn Medina's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Jacquelyn Medina enrolled in Medicare?

Yes. Jacquelyn 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 organization bills Medicare for Jacquelyn Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Medina reassigns Medicare benefits to Aqua Dermatology Of Florida, PA (Palm Beach Gardens, FL). The 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 Jacquelyn Medina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacquelyn Medina accept?

Health plans from AmeriHealth Caritas Next, AvMed, Cigna HealthCare of Florida, Inc., Cigna Healthcare and Molina Healthcare and 1 other insurer list Jacquelyn Medina as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacquelyn Medina was last updated on July 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.