Jenniviere Homitz-Daniels, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

393799 Issued in OH

Practice address

8701 Mentor Ave
Mentor, OH 44060-6103

Phone

(440) 266-0770

Fax

(440) 266-0257

NPI assigned

Aug 24, 2016

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Behavioral Health Services, LLCGroup PAC ID 6507921046, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.18 of 100Reported as group

Quality

55.64

Improvement activities

40

Cost

76.42

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jenniviere.homitz-daniels@pbhsohio.direct.emds.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.

• Premier Behavioral Health Services, LLC

  • Clinical Psychologist
  • Mentor, OH
  • NPI 1184869786
  Medicare reassignment Care Compare group
• B. Sharif MD, Inc

  • Psychiatry Physician
  • Mentor, OH
  • NPI 1922287382
  NPD (past)

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1174078638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606103",
            "telephone_number": "440-266-0770",
            "fax_number": "440-266-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606103",
            "telephone_number": "440-266-0770",
            "fax_number": "440-266-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMITZ-DANIELS",
        "first_name": "JENNIVIERE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "393799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hollys Hearing Aid Center, LLC
• Robyn M Holman
• Kenneth James Holt, LISW-S, LICDC
• Home Infusion Care, Inc.
• Homewatch Caregivers of Lake County
• Paul Homitz-Daniels, AGNP-C
• Nicholas Honkala
• Mary Hooper, MSW, LSW
• Hopebridge, LLC
• Hopeful Journeys Counseling and Wellness Inc.

• Psychiatric/Mental Health Nurse Practitioner in Mentor, OH
• Providers in Mentor, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.