NPIMap

Organization Active NPI

Vein Specialists at Royal Palm Square Inc

  • Vascular Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1124205349
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME94904 Issued in FL
Legal business name
VEIN SPECIALISTS AT ROYAL PALM SQUARE INC
Practice address
1510 Royal Palm Square Blvd
Ste. 101
Fort Myers, FL 33919-1068
Phone
(239) 694-8346
Fax
(239) 936-6272
NPI assigned
Jan 30, 2008
Last updated
Oct 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Authorized official

Name
Dr. Joseph George Magnant, M.D.NPI 1588682728
Title
M.D.
Phone
(239) 694-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X ME94904 FL Primary

Addresses

Primary practice location

1510 Royal Palm Square Blvd
Ste. 101
Fort Myers, FL 33919-1068

Mailing address

1510 Royal Palm Square Blvd
Ste. 101
Fort Myers, FL 33919-1068
Phone (239) 694-8346

Other names 1

  • Joseph G. Magnant, MD Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080806000295 FL Part B Supplier - Clinic/Group Practice 7214001494 Receives reassigned benefits from 17 practitioners
Practice locations: Fort Myers, FL; Bonita Springs, FL

National Provider Directory

National Provider Directory

Locations

3359 Woods Edge Cir
Bonita Springs, FL 34134
Phone (239) 694-8346

3359 Woods Edge Cir
Ste 102
Bonita Springs, FL 34134
Phone (239) 694-8346

1500 Royal Palm Square Blvd
Ste 105
Fort Myers, FL 33919
Phone (239) 275-6778

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1124205349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 ROYAL PALM SQUARE BLVD",
            "address_2": "STE. 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191068",
            "telephone_number": "239-694-8346",
            "fax_number": "239-936-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 ROYAL PALM SQUARE BLVD",
            "address_2": "STE. 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191068",
            "telephone_number": "239-694-8346",
            "fax_number": "239-936-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN SPECIALISTS AT ROYAL PALM SQUARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "MAGNANT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "239-694-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME94904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joseph G. Magnant, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.