Jaclyn S Bellassai, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN9311008 Issued in FL

Practice address

8416 Tidal Breeze Dr
Riverview, FL 33569

Phone

(813) 403-4423

Fax

(813) 433-3124

NPI assigned

Sep 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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, 2018

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

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1871076992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8416 TIDAL BREEZE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335694722",
            "telephone_number": "813-403-4423",
            "fax_number": "813-433-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8416 TIDAL BREEZE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33569",
            "telephone_number": "813-403-4423",
            "fax_number": "813-433-3124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 30th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337103102",
            "country_code": "US",
            "telephone_number": "727-381-4463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1929 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449202",
            "country_code": "US",
            "telephone_number": "813-991-1293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1929 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449202",
            "country_code": "US",
            "telephone_number": "813-991-1293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5357 Ehrlich Rd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33625",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLASSAI",
        "first_name": "JACLYN",
        "middle_name": "S",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP93110008",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9311008",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9311008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Beighley
• Vanessa Belidor
• Darlene Belizaire
• Juliana Bell, OTR/L
• Mariah S Bell
• Abdel Bello
• Desiree M Bello, RDMS
• David Belloso, M.D.
• Abdelkader Benchira
• Benchmark Gastro, L.L.C.

• Psychiatric/Mental Health Nurse Practitioner in Riverview, FL
• Providers in Riverview, 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 Nov 7, 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.