Individual provider Active NPI

Ross W Kravetz, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1053694877
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106158 Issued in FL
Practice address
12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone
(239) 482-2663
Fax
(239) 482-7585
NPI assigned
Sep 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9106158 FL
Physician Assistant 363A00000X PA9106158 FL Primary

Addresses

Primary practice location

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370

Mailing address

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone (239) 482-2663

Other practice location 1

8350 Riverwalk Park Blvd Ste 1
Fort Myers, FL 33919-8759
Phone (239) 482-2663

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
I20111103000665 FL Practitioner - Physician Assistant 5698948891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthopedic Center of Florida, IncGroup PAC ID 9931183639, 48 clinicians

Practice addresses (Care Compare)

12670 Creekside LN
Fort Myers, FL 33919-3370
Phone (239) 482-2663

Hospital & facility affiliations

  • Navigate Home Health Care Home health agency, Cape Coral, FL, CCN 109046
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106158FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Center of Florida, Inc CurrentSince Sep 1, 2022 Accepting new patients
H Morton Bertram III MD Past Accepting new patients

Locations

8350 Riverwalk Park Blvd
Ste 1
Fort Myers, FL 33919
Phone (239) 482-2663

12670 Creekside Ln
Ste 202
Fort Myers, FL 33919
Phone (239) 267-2263

Interoperability endpoints

  • Direct secure messaging: ross.kravetz.1@22724.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1053694877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8350 Riverwalk Park Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339198759",
            "country_code": "US",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAVETZ",
        "first_name": "ROSS",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-28",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106158",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.