Individual provider Active NPI

Gabriella Iacono, PA-C

  • Physician Assistant
  • Cape Coral, FL
National Provider Identifier
1063301901
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9120440 Issued in FL
Practice address
636 Del Prado Blvd S
Cape Coral, FL 33990-2668
Phone
(239) 424-2354
NPI assigned
Jul 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9120440 FL Primary

Addresses

Primary practice location

636 Del Prado Blvd S
Cape Coral, FL 33990-2668

Mailing address

323 Trenton Ave
Barrington, NJ 08007-1061
Phone (856) 200-5604

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
I20251121003340 FL Practitioner - Physician Assistant 6507358082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Coral Emergency Physicians LLCGroup PAC ID 1557465325, 11 clinicians

Practice addresses (Care Compare)

636 Del Prado Blvd S
Emergency Dept
Cape Coral, FL 33990-2668
Phone (239) 424-2000

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9120440FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Coral Emergency Physicians LLC CurrentSince Aug 3, 2025 Accepting new patients

Locations

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

Organizations & group practices 1

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 1

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": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1063301901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 TRENTON AVE",
            "city": "BARRINGTON",
            "state": "NJ",
            "postal_code": "080071061",
            "telephone_number": "856-200-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902668",
            "telephone_number": "239-424-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACONO",
        "first_name": "GABRIELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9120440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.