Individual provider Active NPI

Jennifer Zaccaria, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Venice, FL
National Provider Identifier
1467136242
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11026754 Issued in FL
Practice address
421 Commercial CT Ste B
Venice, FL 34292-1656
Phone
(941) 244-4377
NPI assigned
Jun 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11026754 FL Primary

Addresses

Primary practice location

421 Commercial CT Ste B
Venice, FL 34292-1656

Mailing address

421 Commercial CT Ste B
Venice, FL 34292-1656
Phone (941) 244-4377

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
I20231013001453 FL Practitioner - Nurse Practitioner 9739534595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5325 E State Rd 64 B
Elite Dna Therapy Services
Bradenton, FL 34208-5534
Phone (239) 223-2751

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11026754FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Oct 1, 2023 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

5325 E State Road 64
Ste B
Bradenton, FL 34208
Phone (813) 970-3402

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

421 Commercial Ct
Ste B
Venice, FL 34292
Phone (941) 244-4377

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: jennifer.zaccaria.1@13142.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1467136242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 COMMERCIAL CT STE B",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921656",
            "telephone_number": "941-244-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 COMMERCIAL CT STE B",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921656",
            "telephone_number": "941-244-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACCARIA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11026754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.