Tressa Bonasso

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

106662 Issued in WV

Practice address

23 Tresara Dr
Fairmont, WV 26554-8837

Phone

(304) 694-5898

NPI assigned

Feb 17, 2021

Last updated

Aug 23, 2023By the provider in NPPES

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 WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment NPD
• West Virginia University Medical Corporation

  dba Crisis Support and Recovery Center

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD
• West Virginia University Medical Corporation

  dba WVU Obstetrics & Gynecology-Bridgeport

  • Clinical Medical Laboratory
  • Bridgeport, WV
  • NPI 1457605404
  NPD

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1124611454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 TRESARA DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548837",
            "telephone_number": "304-694-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 TRESARA DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265548837",
            "telephone_number": "304-694-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONASSO",
        "first_name": "TRESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "106662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Rose Bolyard
• Cynthia Leah Bonafield, DDS
• Franklin David Bonasso, DDS
• Patrick Corkrean Bonasso, MD
• Sarah Bonasso, PNP
• Marilyn Judy Bonfili, MD
• Taylor Bonnett
• Barbara Arlene Boone
• Lauren Elizabeth Boros
• Lionel Wendell Bourne

• Pediatric Nurse Practitioner in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Pediatric Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.