Individual provider Active NPI

Eileen M Cohen, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1013979731
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101411 Issued in FL
Practice address
14551 Hope Center Loop Ste 200
Fort Myers, FL 33912-4705
Phone
(239) 264-7026
Fax
(239) 567-3679
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA9101411 FL
Physician Assistant 363A00000X PA9101411 FL Primary

Addresses

Primary practice location

14551 Hope Center Loop Ste 200
Fort Myers, FL 33912-4705

Mailing address

PO Box 749495
Atlanta, GA 30374-9495
Phone (855) 963-2100

Other practice location 1

632 Del Prado Blvd N Ste 101
Cape Coral, FL 33909-2278
Phone (239) 772-5577

Other practice location 2

12700 Creekside Ln Ste 101
Fort Myers, FL 33919-3356
Phone (239) 432-0774 ext. 5061

Other practice location 3

12600 Creekside Ln Ste 300
Fort Myers, FL 33919-3353
Phone (239) 772-5577

Other practice location 4

8260 Gladiolus Dr
Fort Myers, FL 33908-4156
Phone (239) 437-5755

Other identifiers 4

IdentifierTypeStateIssuer
291064100MedicaidFL
970019944OtherFLMEDICAID RR
PA9101411OtherFLPA LICENSE
2911064100MedicaidFL

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
I20040401001457 FL Practitioner - Physician Assistant 4688666225 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Feb 28, 2022 Accepting new patients
Orthopedic Specialists of SW Florida, P.a. Past Accepting new patients

Locations

8260 Gladiolus Dr
Fort Myers, FL 33908
Phone (239) 437-5755

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1013979731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749495",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749495",
            "telephone_number": "855-963-2100",
            "fax_number": "813-321-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14551 HOPE CENTER LOOP STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124705",
            "telephone_number": "239-264-7026",
            "fax_number": "239-567-3679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Del Prado Blvd N Ste 101",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339092278",
            "country_code": "US",
            "telephone_number": "239-772-5577",
            "fax_number": "239-573-1528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12700 Creekside Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339193356",
            "country_code": "US",
            "telephone_number": "239-432-0774 x5061",
            "fax_number": "239-432-9404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12600 Creekside Ln Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339193353",
            "country_code": "US",
            "telephone_number": "239-772-5577",
            "fax_number": "239-573-1528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8260 Gladiolus Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339084156",
            "country_code": "US",
            "telephone_number": "239-437-5755",
            "fax_number": "239-437-5776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "EILEEN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101411",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291064100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID RR",
            "identifier": "970019944",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA9101411",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2911064100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.