Jonathan Rene Broniste, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A03206 Issued in AR

Practice address

603 S Division St
Lavaca, AR 72941-4129

Phone

(479) 674-9181

Fax

(479) 674-8105

NPI assigned

Mar 17, 2009

Last updated

Sep 23, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 AR

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians

River Valley Primary Care ServicesGroup PAC ID 0042274276, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kindred at Home 1 Home health agency, Fort Smith, AR, CCN 047038
• Elite Home Health Home health agency, Fort Smith, AR, CCN 047339
• Adoration Home Health Home health agency, Van Buren, AR, CCN 047010
• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbroniste589647@direct.ochin.org
• Direct secure messaging: jonathan.broniste.1@6858.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Face 2 Face PLLC

  • Primary Care Clinic/Center
  • Van Buren, AR
  • NPI 1730425448
  Medicare reassignment NPD Authorized official
• River Valley Primary Care Services

  • Federally Qualified Health Center (FQHC)
  • Ratcliff, AR
  • NPI 1952349003
  Medicare reassignment Care Compare group NPD
• F&S Physical Therapy, Inc.

  • Physical Therapist
  • Alma, AR
  • NPI 1518936418
  Care Compare group
• River Valley Primary Care Services

  dba Mountainburg Community Pharmacy

  • Community/Retail Pharmacy
  • Mountainburg, AR
  • NPI 1164222113
  NPD
• River Valley Primary Care Services

  dba Waldron Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Waldron, AR
  • NPI 1992212013
  NPD
• Cisterna Emergency Physicians LLC

  • Emergency Medicine Physician
  • Fort Smith, AR
  • NPI 1306178371
  NPD (past)

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

• Amedisys Arkansas, LLC

  dba Adoration Home Health

  • Home Health Agency
  • Van Buren, AR
  • NPI 1346208758
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  dba CenterWell Home Health

  • Home Health Agency
  • Fort Smith, AR
  • NPI 1619909884
  Care Compare affiliation
• LHCG Xlii, LLC

  dba Elite Home Health

  • Home Health Agency
  • Fort Smith, AR
  • NPI 1154668895
  Care Compare affiliation
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1275774440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S DIVISION ST",
            "city": "LAVACA",
            "state": "AR",
            "postal_code": "729414129",
            "telephone_number": "479-674-9181",
            "fax_number": "479-674-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S DIVISION ST",
            "city": "LAVACA",
            "state": "AR",
            "postal_code": "729414129",
            "telephone_number": "479-674-9181",
            "fax_number": "479-674-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONISTE",
        "first_name": "JONATHAN",
        "middle_name": "RENE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A03206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "A03206",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Ahlert, PHARMD
• Area Agency on Aging of Western Arkansas, Inc
• Area Agency on Aging of Western Arkansas, Inc
• Katie Renee Davidson, COTA/L
• Ciara Fleer
• Ruth Ann Groff
• HNK Pharm, PLLC
• HNK Pharm, PLLC

• Nurse Practitioner in Lavaca, AR
• Providers in Lavaca, AR by specialty
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.