Individual provider Active NPI

Alvaro Boniche, M.D.

  • Hospitalist Physician
  • Fort Myers, FL
National Provider Identifier
1104112465
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME120192 Issued in FL
Practice address
9981 S Healthpark Dr
Fort Myers, FL 33908
Phone
(239) 343-2052
Fax
(239) 343-5348
NPI assigned
Jun 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME120192 FL Primary

Addresses

Primary practice location

9981 S Healthpark Dr
Fort Myers, FL 33908

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-2052

Other identifiers 1

IdentifierTypeStateIssuer
013088800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aboniche86961@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
I20140917001837 FL Practitioner - HospitalistPractitioner - Internal Medicine 2062631468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME120192FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Family Medicine CurrentSince Sep 6, 2017 Accepting new patients
Lee Memorial Health System CurrentSince Sep 6, 2017 Accepting new patients
Lee Health System Inc Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Internal Medicine Associates of Lee County MD PA Past Accepting new patients

Locations

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

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

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

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

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

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: aboniche86961@direct.leememorial.org

Organizations & group practices 5

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 3

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1104112465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-2052",
            "fax_number": "239-343-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 S HEALTHPARK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-343-2052",
            "fax_number": "239-343-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONICHE",
        "first_name": "ALVARO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME120192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013088800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aboniche86961@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 Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.