Organization Active NPI

Medicalmastersorg

  • Internal Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1063193589
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICALMASTERSORG
Practice address
9200 Bonita Beach Rd SE Ste 113
Bonita Springs, FL 34135-4278
Phone
(239) 908-4711
Fax
(239) 444-4702
NPI assigned
Jul 27, 2023
Last updated
May 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Dr. Steven Coleman, DONPI 1134310444
Title
President
Phone
(239) 908-4711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9200 Bonita Beach Rd SE Ste 113
Bonita Springs, FL 34135-4278

Mailing address

9200 Bonita Beach Rd SE Ste 113
Bonita Springs, FL 34135-4278
Phone (239) 908-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250514001414 FL Part B Supplier - Clinic/Group Practice 8123546173 Receives reassigned benefits from 1 practitioner
Practice locations: Bonita Springs, FL

National Provider Directory

National Provider Directory

Locations

9200 Bonita Beach Rd SE
Ste 113
Bonita Springs, FL 34135
Phone (239) 908-4711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1063193589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE STE 113",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354278",
            "telephone_number": "239-908-4711",
            "fax_number": "239-444-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE STE 113",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354278",
            "telephone_number": "239-908-4711",
            "fax_number": "239-444-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICALMASTERSORG",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-908-4711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.