Individual provider Active NPI

Jacqueline Bonny Larrea, A.R.N.P.

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1083009328
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9263016 Issued in FL
Practice address
1817 N Mills Ave
Orlando, FL 32803-1853
Phone
(407) 896-1726
Fax
(407) 241-3259
NPI assigned
Apr 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9263016 FL Primary

Addresses

Primary practice location

1817 N Mills Ave
Orlando, FL 32803-1853

Mailing address

1817 N Mills Ave
Orlando, FL 32803-1853
Phone (407) 896-1726

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150730013557 FL Practitioner - Nurse Practitioner 8426362740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Assoc of Central FLGroup PAC ID 1456331545, 12 clinicians

Practice addresses (Care Compare)

1817 N Mills Ave
Orlando, FL 32803-1853
Phone (407) 896-1726

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.41 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
74.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9263016FLMDFamily Nurse Practitioner

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1083009328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031853",
            "telephone_number": "407-896-1726",
            "fax_number": "407-241-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031853",
            "telephone_number": "407-896-1726",
            "fax_number": "407-241-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARREA",
        "first_name": "JACQUELINE",
        "middle_name": "BONNY",
        "name_prefix": "Miss",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9263016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.