Individual provider Active NPI

Shawn B Miller, MD

  • Internal Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1124106745
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME80489 Issued in FL
Practice address
9500 Bonita Beach Rd SE Ste 302
Bonita Springs, FL 34135-4698
Phone
(239) 319-2201
Fax
(239) 319-2202
NPI assigned
Nov 1, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME80489 FL Primary

Addresses

Primary practice location

9500 Bonita Beach Rd SE Ste 302
Bonita Springs, FL 34135-4698

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
ME80489OtherFLSTATE LICENSE NUMBER
51538AOtherFLMC ID

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
I20040116000570 FL Practitioner - Internal Medicine 4981504974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

11181 Health Park Blvd
Naples, FL 34110-5743

12995 S Cleveland Ave
Suite 184
Fort Myers, FL 33907-7703
Phone (239) 939-2201

13691 Metro Pkwy
Fort Myers, FL 33912-4322

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

1495 Pine Ridge Rd
Suite 4
Naples, FL 34109-2113
Phone (239) 594-5456

1735 SW Health Pkwy
Suite 201
Naples, FL 34109-0421
Phone (239) 249-7800

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

27160 Bay Landing Dr
Suite 201
Bonita Springs, FL 34135-4301
Phone (239) 366-5062

3369 Pine Ridge Rd
Unit 203
Naples, FL 34109-3932
Phone (239) 631-2662

3434 Hancock Bridge Pkwy
Suite 301
North Fort Myers, FL 33903-7099
Phone (877) 856-3774

400 8TH St N
Naples, FL 34102-5519
Phone (239) 261-5511

6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone (239) 649-3312

6376 Pine Ridge Rd
Suite 440
Naples, FL 34119-3905
Phone (239) 307-6972

800 Goodlette N Rd
Suite 200
Naples, FL 34102-5408
Phone (239) 719-3362

800 Goodlette Rd
Suite 205
Naples, FL 34102-5408
Phone (239) 315-7538

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Aug 19, 2013 Accepting new patients
Redi Med of Bonita Springs LLC Internal Medicine CurrentSince Sep 1, 2006 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Aug 19, 2013 Accepting new patients
Redi Med LLC PastSince Jun 29, 2004 Accepting new patients
Naples Urgent Care PL Internal Medicine PastSince Jul 19, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9400 Bonita Beach Rd SE
Ste 101
Bonita Springs, FL 34135
Phone (239) 333-1177

9500 Bonita Beach Rd SE
Ste 302
Bonita Springs, FL 34135
Phone (239) 319-2201

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

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

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12343/brand/1/csg/1/fhir/r4
  • Direct secure messaging: shawn.miller.1@4290.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1124106745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "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": "9500 BONITA BEACH RD SE STE 302",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354698",
            "telephone_number": "239-319-2201",
            "fax_number": "239-319-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHAWN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "ME80489",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC ID",
            "identifier": "51538A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.