Individual provider Active NPI

Bonnie M Nestler, ARNP

  • Dermatology Physician
  • Port Richey, FL
National Provider Identifier
1255320446
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1939852 Issued in FL
Practice address
8220 US Highway 19
Port Richey, FL 34668-6639
Phone
(727) 841-8505
Fax
(727) 846-0561
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1939852 FL Primary

Addresses

Primary practice location

8220 US Highway 19
Port Richey, FL 34668-6639

Mailing address

8220 US Highway 19
Port Richey, FL 34668-6639
Phone (727) 841-8505

Other identifiers 1

IdentifierTypeStateIssuer
302746501MedicaidFL

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
I20100108000600 FL Practitioner - Nurse Practitioner 1052452356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Dermatology and Cosmetic Surgery P aGroup PAC ID 7517851215, 25 clinicians

Practice addresses (Care Compare)

115 Highland NE Ave
Largo, FL 33770-2530
Phone (727) 585-8591

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1939852FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kratz Allergy Asthma & Immunology Associates PA Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1255320446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346686639",
            "telephone_number": "727-841-8505",
            "fax_number": "727-846-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346686639",
            "telephone_number": "727-841-8505",
            "fax_number": "727-846-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTLER",
        "first_name": "BONNIE",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "1939852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302746501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Richey, FL

Sources for this page

Verify at the official NPI Registry.