Jessica Lynn Vesa, CNP
Individual provider Active NPI Registered Nurse · Youngstown, OH
NPI 1366049439 · NPPES record last updated Feb 22, 2021
Key facts
- NPI
- 1366049439
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN360816 (OH)
- Practice address
- 540 Parmalee Ave Ste 610
Youngstown, OH 44510-1605 - Phone
- (330) 744-4369
- Fax
- (330) 744-1728
- NPI assigned
- Oct 2, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeastern Ohio Infectious Disease Association Inc
Practice addresses (Care Compare)
7000 S Ave
Suite 2
Boardman, OH 44512-3644
Phone (330) 744-4369
Hospital & facility affiliations
- HMHP St Elizabeth Boardman Health Center
- MH St Elizabeth Youngstown Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201102001996 | OH | Practitioner - Nurse Practitioner | 7012327075 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.360816 | OH | MD | Registered Nurse |
| RN360816 | OH | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeastern Ohio Infectious Disease Association Inc | Current |
Accepting new patients | |
| Northeastern Ohio Infectious Disease Association, Inc. | Past | Accepting new patients |
Locations
540 Parmalee Ave
Ste 610
Youngstown, OH 44510
Phone (330) 480-2078
7000 South Ave
Ste 2
Youngstown, OH 44512
Phone (330) 726-3456
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.360816 | OH | |
| Registered Nurse | 163W00000X | RN360816 | OH | Yes |
Addresses
Primary practice location
540 Parmalee Ave Ste 610
Youngstown, OH 44510-1605
Mailing address
PO Box 4012
Youngstown, OH 44515-0012
Phone (330) 270-2350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34-1706671 | Other | TAX ID | |
| 0421475 | Medicaid | OH |
Other names
- Jessica Lynn Tedesco
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | carelink | Health Information Exchange (HIE) |
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.