Individual provider Active NPI

John Stephen Walsh, MD

  • Family Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1033131883
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME145947 Issued in FL
Practice address
313 SW Pine Island Rd
Cape Coral, FL 33991-2043
Phone
(239) 458-6755
NPI assigned
Jul 24, 2006
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 210572 NY
Family Medicine Physician 207Q00000X 274001 MA
Family Medicine Physician 207Q00000X ME145947 FL Primary

Addresses

Primary practice location

313 SW Pine Island Rd
Cape Coral, FL 33991-2043

Mailing address

313 SW Pine Island Rd
Cape Coral, FL 33991-2043
Phone (239) 458-6755

Other identifiers 1

IdentifierTypeStateIssuer
01871796MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA, FL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150814013037 NY Practitioner - Family Practice 1153636501
I20200302001634 MA Practitioner - Family Practice 1153636501
I20250102003414 FL Practitioner - Family Practice 1153636501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

313 SW Pine Island Rd
Cape Coral, FL 33991-2043
Phone (239) 458-6755

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
210572NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Jan 6, 2025 Accepting new patients
MD Now Medical Centers Inc CurrentSince Jan 6, 2025 Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

313 SW Pine Island Rd
Cape Coral, FL 33991
Phone (239) 458-6755

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1033131883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 SW PINE ISLAND RD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912043",
            "telephone_number": "239-458-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 SW PINE ISLAND RD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912043",
            "telephone_number": "239-458-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "210572",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "274001",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME145947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01871796",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.