Destiny Mayo-Juratovic, CRNP

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

SP017240 Issued in PA

Practice address

680 Blair Mill Rd
Horsham, PA 19044-2223

Phone

(800) 765-6808

NPI assigned

Feb 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: destiny.mayo-juratovic.1@22854.direct.athenahealth.com

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.

• Monogram Health Professional Services PC

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  • Brentwood, TN
  • NPI 1134739089

  PA

  Medicare reassignment NPD
• Saint Vincent Medical Education and Research Institute

  • Family Medicine Physician
  • Albion, PA
  • NPI 1558462259
  NPD (past)

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1154860294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "800-765-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO-JURATOVIC",
        "first_name": "DESTINY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "PA",
            "license": "SP017240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "destiny_mayo-juratovic@optum.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "employment info",
            "address_1": "680 Blair Mill Rd",
            "city": "Horsham",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalie Marie Masis, PHD, MS, RD
• Aswin Mathew, M.D.
• Christopher David Mathews, PA
• Anthony Matteo, MD
• Michelle Matuka, CRNP
• Marvin Allen Mazer, PHARMACIST
• Tabitha Wamere Mbugua
• Amy McCaffrey, MS CCC SLP
• James Andrew McCaffrey, M.D.
• Julia Marie McCarrick, CRNP

• Critical Care Medicine Nurse Practitioner in Horsham, PA
• Providers in Horsham, PA by specialty
• Critical Care Medicine Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.