Genevieve Banaag

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11042939 Issued in FL

Practice address

602 S Main St
Gainesville, FL 32601-6718

Phone

(352) 230-5910

NPI assigned

Dec 29, 2025

Sex

Female

Sole proprietor

Yes

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 FL

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 Florida College of Medicine, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Revitalizing Infusion Therapies, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kissimmee, FL
  • NPI 1508485756
  Medicare reassignment

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1013873645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S MAIN ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S MAIN ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016718",
            "telephone_number": "352-230-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAAG",
        "first_name": "GENEVIEVE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11042939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Jordan Baltar
• Caroline Baltrucki, OT
• Katherine Elizabeth Baltzelle
• Marvin R Balza
• Elizabeth Bamiro
• Abdulaziz Banasser, BDS
• Gary Wayne Banfield, D,D,S,
• Grant Patrick Banfill
• Bradley P Bangstad, O.D.
• Lesley Chuc Banh

• Psychiatric/Mental Health Nurse Practitioner in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.