Individual provider Active NPI

Ana Paula Tosta Wiedner, NP

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1053088062
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11026880 Issued in FL
Practice address
3637 Dr Martin Luther King Blvd
Fort Myers, FL 33916-4601
Phone
(239) 343-4910
Fax
(239) 343-4911
NPI assigned
Aug 26, 2021
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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 APRN11026880 FL Primary

Addresses

Primary practice location

3637 Dr Martin Luther King Blvd
Fort Myers, FL 33916-4601

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-4910

Other identifiers 1

IdentifierTypeStateIssuer
119504500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awiedner353604@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220520001009 RI Practitioner - Nurse Practitioner 0244617835 Reassigns benefits to 1 organization
I20230915001900 FL Practitioner - Nurse Practitioner 0244617835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

2441 Surfside Blvd
Cape Coral, FL 33914-3861

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Federally Qualified Health Center (FQHC) CurrentSince Oct 30, 2023 Accepting new patients
Thundermist Health Center Federally Qualified Health Center (FQHC) CurrentSince Feb 9, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Thundermist Health Center Federally Qualified Health Center (FQHC) Current Accepting new patients
Thundermist Health Center Federally Qualified Health Center (FQHC) CurrentSince Feb 9, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 30, 2023 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

3637 Dr Martin Luther King Blvd
Fort Myers, FL 33916
Phone (239) 343-4910

3637 Dr Martin Luther King Blvd
Unit 101
Fort Myers, FL 33916
Phone (239) 343-4910

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

186 Providence St
West Warwick, RI 02893
Phone (401) 615-2800

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

  • Direct secure messaging: awiedner353604@direct.leememorial.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 7

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1053088062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-4910",
            "fax_number": "239-343-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 DR MARTIN LUTHER KING BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339164601",
            "telephone_number": "239-343-4910",
            "fax_number": "239-343-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDNER",
        "first_name": "ANA PAULA",
        "middle_name": "TOSTA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11026880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119504500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awiedner353604@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.