Jessa Bonavia, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11027499 Issued in FL

Practice address

1220 Willis Ave
Daytona Beach, FL 32114-2810

Phone

(800) 539-4228

NPI assigned

Jul 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dr Luisa Vega DNP LLC

  • Nurse Practitioner
  • Lake Mary, FL
  • NPI 1497123319

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Sma Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Daytona Beach, FL
  • NPI 1356329163
  Medicare reassignment NPD
• Sma Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1255950168
  NPD

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1780365205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "386-236-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 WILLIS AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142810",
            "telephone_number": "800-539-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAVIA",
        "first_name": "JESSA",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11027499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Bogunovic, DPM
• Carla Bohnstedt
• Deanna Boicourt, RN
• Rachel Elizabeth Boldman
• Janae Bolling
• Ines Bonila
• Claudina A Bonilla, M.D.
• Garner Boogaerts, MD, MPH
• Savannah Booker
• Jeremy Booms, CRNA

• Psychiatric/Mental Health Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.