Individual provider Active NPI

Jessica L. Misiti, ARNP

  • Diagnostic Radiology Physician
  • El Segundo, CA
National Provider Identifier
1477926053
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1477926053 Issued in FL
Practice address
2330 Utah Ave
El Segundo, CA 90245-4817
Phone
(424) 290-8004
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9274400 FL
Diagnostic Radiology Physician 2085R0202X 1477926053 FL Primary

Addresses

Primary practice location

2330 Utah Ave
El Segundo, CA 90245-4817

Mailing address

2330 Utah Ave
El Segundo, CA 90245-4817
Phone (424) 290-8004

Other names 1

  • Jessica L. Ventura Former name

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
I20171219001276 FL Practitioner - Nurse Practitioner 3779841861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

1728 Hansen St
Sarasota, FL 34231-3518
Phone (904) 399-5550

1809 S Osprey Ave
Sarasota, FL 34239-3614
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2600 Laurel Rd E
Nokomis, FL 34275-3226
Phone (904) 399-5550

4761 Sacra CT
Sarasota, FL 34240-4712
Phone (904) 399-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1477926053FLMDDiagnostic Radiology Physician
9274400FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients

Locations

2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

2716 University Square Dr
Tampa, FL 33612
Phone (813) 971-2050

2700 University Square Dr
Tampa, FL 33612
Phone (813) 251-5822

2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-1191

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1477926053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 UTAH AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454817",
            "telephone_number": "424-290-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 UTAH AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454817",
            "telephone_number": "424-290-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISITI",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9274400",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "1477926053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VENTURA",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.