Individual provider Active NPI

Carlos Javier Collado-Rivera, MD

  • Hospitalist Physician
  • Fort Myers, FL
National Provider Identifier
1063093763
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME167510 Issued in FL
Practice address
6150 Medical Park Loop
Fort Myers, FL 33912-4537
Phone
(239) 722-3600
Fax
(239) 772-3995
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME167510 FL Primary

Addresses

Primary practice location

6150 Medical Park Loop
Fort Myers, FL 33912-4537

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-2052

Other practice location 1

Mather Hospital Internal Medicine Residency Program
Level 2 - CMO Suite 75 N Country Rd
Port Jefferson, NY 11777
Phone (631) 686-1443

Other practice location 2

9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-2052

Other identifiers 1

IdentifierTypeStateIssuer
123497700MedicaidFL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819004318 FL Practitioner - Hospitalist 9234677428 Reassigns benefits to 2 organizations

Care Compare profile

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

Practice addresses (Care Compare)

9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-2606

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME167510FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Jan 18, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Sep 10, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Sep 10, 2024 Accepting new patients
Lee Health System Inc CurrentSince Jan 18, 2025 Accepting new patients

Locations

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

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

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

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

6150 Medical Park Loop
Fort Myers, FL 33912
Phone (239) 722-3600

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ccolladorivera410946@direct.leememorial.org

Organizations & group practices 4

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 3

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1063093763",
    "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": "239-343-2052",
            "fax_number": "239-343-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 MEDICAL PARK LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124537",
            "telephone_number": "239-722-3600",
            "fax_number": "239-772-3995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mather Hospital Internal Medicine Residency Program",
            "address_2": "Level 2 - CMO Suite 75 N Country Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "11777",
            "country_code": "US",
            "telephone_number": "631-686-1443",
            "fax_number": "631-686-7651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9981 S Healthpark Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083618",
            "country_code": "US",
            "telephone_number": "239-343-2052",
            "fax_number": "239-343-5348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLADO-RIVERA",
        "first_name": "CARLOS",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME167510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123497700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.