Individual provider Active NPI

Doris Ann Hayes, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1083690952
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME111545 Issued in FL
Practice address
21297 Olean Blvd Ste a
Port Charlotte, FL 33952-6704
Phone
(855) 979-5700
Fax
(855) 979-5701
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038274 CT
Internal Medicine Physician 207R00000X 219081-1 NY
Internal Medicine Physician 207R00000X ME111545 FL Primary

Addresses

Primary practice location

21297 Olean Blvd Ste a
Port Charlotte, FL 33952-6704

Mailing address

2675 Winkler Ave FL 2Floor
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
14HX8OtherFLBLUE SHIELD

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
I20111229000650 FL Practitioner - HospitalistPractitioner - Internal Medicine 5698713949 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219081-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Nov 30, 2011 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Nov 30, 2011 Accepting new patients
Millennium Physician Group LLC CurrentSince Dec 1, 2012 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Dec 1, 2012 Accepting new patients
RLD Medical Services, PC Internal Medicine PastSince Jul 1, 2001 Accepting new patients
Becker Medical, PC Past Accepting new patients
Mount Sinai School of Medicine Internal Medicine Past Accepting new patients
Forest Hills Dermatology Group PLLC PastSince Sep 1, 2012 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

3434 Hancock Bridge Pkwy
North Ft Myers, FL 33903

2315 Aaron St
Port Charlotte, FL 33952
Phone (941) 613-2222

2351 Aaron St
Port Charlotte, FL 33952
Phone (855) 674-7500

21297 Olean Blvd
#A
Pt Charlotte, FL 33952
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1083690952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2FLOOR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21297 OLEAN BLVD STE A",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526704",
            "telephone_number": "855-979-5700",
            "fax_number": "855-979-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "DORIS",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038274",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219081-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME111545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "14HX8",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.