Active NPI
Peter H. Blitzer, MD
- Radiation Oncology Physician
- Fort Myers, FL
National Provider Identifier
1043214539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- ME0047908
- Practice address
- 7341 Gladiolus Dr
Fort Myers, FL 33908-5122 - Phone
- (239) 489-3420
- Fax
- (239) 489-3219
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | ME0047908 | FL | Primary |
Addresses
Primary practice location
7341 Gladiolus Dr
Fort Myers, FL 33908-5122
Mailing address
2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24-05257 | Other | FL | UHC PROVIDER NUMBER |
| 0053977-017 | Other | FL | CIGNA PROVIDER NUMBER |
| 202575 | Other | FL | AVMED PROVIDER NUMBER |
| 85445 | Other | FL | OP. ENG. LOC. 825 PROV. # |
| 00788 | Other | FL | UNV. HLTHCR. PROVIDER # |
| 0624230 | Other | FL | AETNA HMO PROVIDER NUMBER |
| 90546 | Other | FL | FIRST HEALTH PROVIDER NUM |
| 920004623 | Other | FL | RAILROAD MEDICARE |
| ME47908A | Other | FL | METCARE PROVIDER ID # |
| 4129691 | Other | FL | AETNA OTHER PROVIDER NUM. |
| 592485899 | Other | FL | METCARE VENDOR ID # |
| 045283100 | Medicaid | FL | |
| 273709 | Other | FL | GREAT WEST REFERENCE NUM. |
| 73297 | Other | FL | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0047908 | FL | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1043214539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2234 COLONIAL BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339071412",
"telephone_number": "239-931-7342",
"fax_number": "239-931-7385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7341 GLADIOLUS DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339085122",
"telephone_number": "239-489-3420",
"fax_number": "239-489-3219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLITZER",
"first_name": "PETER",
"middle_name": "H.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "FL",
"license": "ME0047908",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC PROVIDER NUMBER",
"identifier": "24-05257",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "0053977-017",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED PROVIDER NUMBER",
"identifier": "202575",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OP. ENG. LOC. 825 PROV. #",
"identifier": "85445",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNV. HLTHCR. PROVIDER #",
"identifier": "00788",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO PROVIDER NUMBER",
"identifier": "0624230",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH PROVIDER NUM",
"identifier": "90546",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "920004623",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METCARE PROVIDER ID #",
"identifier": "ME47908A",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA OTHER PROVIDER NUM.",
"identifier": "4129691",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METCARE VENDOR ID #",
"identifier": "592485899",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "045283100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST REFERENCE NUM.",
"identifier": "273709",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "73297",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.