Individual provider Active NPI

Albertus B Van Zyl, M.D.

  • Family Medicine Physician
  • Ft Myers, FL
National Provider Identifier
1063409423
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0078133 Issued in FL
Practice address
5225 Clayton CT
Ft Myers, FL 33907-2117
Phone
(239) 343-8240
Fax
(239) 343-8241
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0078133 FL Primary

Addresses

Primary practice location

5225 Clayton CT
Ft Myers, FL 33907-2117

Mailing address

PO Box 2147
Ft Myers, FL 33902-2147
Phone (239) 343-8240

Other identifiers 1

IdentifierTypeStateIssuer
257882400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avanzyl90@Direct.leememorial.org Lee Memorial Health System

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000472 FL Practitioner - Family Practice 0941338172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
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

5225 Clayton CT
Fort Myers, FL 33907-2117
Phone (239) 939-7222

Hospital & facility affiliations

  • Lee Memorial Home Health, Inc. Home health agency, Fort Myers, FL, CCN 107191
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0078133FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Feb 4, 2002 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Family Medicine Current Accepting new patients

Locations

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

5225 Clayton Ct
Fort Myers, FL 33907
Phone (239) 343-8240

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

14171 Metropolis Ave
Ste 101
Fort Myers, FL 33912
Phone (239) 320-8140

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

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

Interoperability endpoints

  • Direct secure messaging: avanzyl90@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 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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1063409423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-8240",
            "fax_number": "239-343-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CLAYTON CT",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339072117",
            "telephone_number": "239-343-8240",
            "fax_number": "239-343-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ZYL",
        "first_name": "ALBERTUS",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0078133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257882400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avanzyl90@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "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 Ft Myers, FL

Sources for this page

Verify at the official NPI Registry.