David J Ayala, CRNA

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

• Adventist Health Hanford Hospital · Hanford, CA

Colleagues at Comfort Anesthesia Associates Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 80 clinicians in the practice; 12 are shown here.

• Dr. Cesario Dayahan, MD Anesthesiology Physician · Los Angeles, CA
• Trevr W Eborn Registered Nurse · Lemoore, CA
• Jonica Lynn Goetsch-Stingl, CRNA Certified Registered Nurse Anesthetist · Brawley, CA
• Dr. Joseph Ipe, MD Anesthesiology Physician · Porterville, CA
• Priya Kachhwaha, MD Anesthesiology Physician · Bakersfield, CA
• John Sturges Miller, CRNA Certified Registered Nurse Anesthetist · Bakersfield, CA
• Katarzyna Mosley, CRNA Certified Registered Nurse Anesthetist · Hanford, CA
• Mr. Alex Preston, MD Anesthesiology Physician · Porterville, CA
• Gerardo R Princesa, MD Anesthesiology Physician · Spencer, WV
• Dr. Jose Alberto Rodriguez, DNP, CRNA, APRN Registered Nurse · Hanford, CA
• Anselmo Serna, CRNA Certified Registered Nurse Anesthetist · Porterville, CA
• Jacob Smith, CRNA Certified Registered Nurse Anesthetist · Bakersfield, CA

Other providers in Brawley

• Rachael Deann Donahue, PA

  Individual Student in an Organized Health Care Education/Training Program · NPI 1982429254

  Student / training record Brawley, CA

• Vidhi Gupta

  Individual Student in an Organized Health Care Education/Training Program · NPI 1740717966

  Student / training record Brawley, CA

• Trang Lee

  Individual Student in an Organized Health Care Education/Training Program · NPI 1356863997

  Student / training record Brawley, CA

• George Rapp, MD

  Individual Student in an Organized Health Care Education/Training Program · NPI 1114217015

  Student / training record Brawley, CA