Individual provider Active NPI

Brian Menichello, MD

  • Family Medicine Physician
  • Naples, FL
National Provider Identifier
1104025790
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME113559 Issued in FL
Practice address
15420 Collier Blvd
Naples, FL 34120
Phone
(239) 624-0600
Fax
(239) 624-0601
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 ME113559 FL Primary

Addresses

Primary practice location

15420 Collier Blvd
Naples, FL 34120

Mailing address

15420 Collier Blvd
Naples, FL 34120
Phone (239) 624-0600

Other identifiers 2

IdentifierTypeStateIssuer
14M1BOtherFLBCBS
024264900MedicaidFL

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
I20120920000514 FL Practitioner - Family Practice 7012007651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Moorings IncorporatedGroup PAC ID 4688832066, shared by 2 NPIs, 116 clinicians
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

120 Moorings Park Dr
Naples, FL 34105-2122

130 Moorings Park Dr
Naples, FL 34105-2122

15420 Collier Blvd
Naples, FL 34120-3917
Phone (239) 624-0600

Hospital & facility affiliations

  • Pinnacle Home Care Home health agency, Fort Myers, FL, CCN 683113
  • Naples Community Hospital Hospital, Naples, FL, CCN 100018

Merit-based Incentive Payment System (MIPS)

Final score
95.25 of 100Reported as apm
Quality
87.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd Inc CurrentSince Jan 5, 2015 Accepting new patients
Collier Hma Physician Management LLC CurrentSince Sep 4, 2012 Accepting new patients
Nchmd, Inc CurrentSince Jan 5, 2015 Accepting new patients
Collier Hma Physician Management LLC Family Medicine CurrentSince Sep 4, 2012 Accepting new patients

Locations

15420 Collier Blvd
Naples, FL 34120
Phone (239) 624-0600

11181 Health Park Blvd
Ste 2230
Naples, FL 34110
Phone (239) 594-2700

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

Interoperability endpoints

  • Direct secure messaging: bmenichello23077@nchhealthcaresystem.direct-ci.com

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 2

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1104025790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34120",
            "telephone_number": "239-624-0600",
            "fax_number": "239-624-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34120",
            "telephone_number": "239-624-0600",
            "fax_number": "239-624-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENICHELLO",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME113559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14M1B",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024264900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.