Individual provider Active NPI

Bonita Rita Moynihan

  • Family Nurse Practitioner
  • Dunedin, FL
National Provider Identifier
1922774066
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11014648 Issued in FL
Practice address
2812 Saint Marks Dr
Dunedin, FL 34698-1926
Phone
(727) 328-4633
Fax
(727) 726-0529
NPI assigned
Aug 18, 2021
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11014648 FL Primary

Addresses

Primary practice location

2812 Saint Marks Dr
Dunedin, FL 34698-1926

Mailing address

569 Heritage Oaks CT
Tarpon Springs, FL 34689-1710
Phone (727) 938-6467

Other practice location 1

601 Main St
Dunedin, FL 34698-5848
Phone (727) 802-8203

Other practice location 2

29335 US Highway 19 N
Clearwater, FL 33761-2146
Phone (727) 739-9826

Other practice location 3

7322 US Highway 19 N
Pinellas Park, FL 33781-4600
Phone (727) 349-4981

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bonita.moynihan.1@29601.direct.athenahealth.com

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
I20230131000814 FL Practitioner - Nurse Practitioner 3678944667 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014648FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc CurrentSince Nov 6, 2023 Accepting new patients
Pophealthcare, LLC Family CurrentSince Mar 8, 2026 Accepting new patients
Bowman & Hampsey Medical Clinic, Inc CurrentSince Oct 13, 2022 Accepting new patients
Pophealthcare, LLC CurrentSince Mar 8, 2026 Accepting new patients
Conviva Medical Center Management LLC CurrentSince Aug 3, 2026 Accepting new patients

Locations

3251 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 725-6110

2812 Saint Marks Dr
Dunedin, FL 34698
Phone (727) 328-4633

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

10739 Deerwood Park Blvd
Ste 200
Jacksonville, FL 32256
Phone (615) 721-7024

36440 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 786-0696

7322 US Highway 19 N
Pinellas Park, FL 33781
Phone (727) 349-4981

960 58th St N
St Petersburg, FL 33710
Phone (727) 820-7778

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

15320 Amberly Dr
Ste A
Tampa, FL 33647
Phone (813) 977-0733

Organizations & group practices 6

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1922774066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 HERITAGE OAKS CT",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346891710",
            "telephone_number": "727-938-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 SAINT MARKS DR",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346981926",
            "telephone_number": "727-328-4633",
            "fax_number": "727-726-0529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Main St",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346985848",
            "country_code": "US",
            "telephone_number": "727-802-8203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29335 US Highway 19 N",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612146",
            "country_code": "US",
            "telephone_number": "727-739-9826",
            "fax_number": "877-409-4104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7322 US Highway 19 N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337814600",
            "country_code": "US",
            "telephone_number": "727-349-4981",
            "fax_number": "888-830-1631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "BONITA",
        "middle_name": "RITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bonita.moynihan.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2812 Saint Marks Dr",
            "city": "Dunedin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346981926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.