Individual provider Active NPI

Jean-Paul Alishahi, DO

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1124686118
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS19041 Issued in FL
Practice address
2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone
(855) 979-5700
Fax
(855) 979-5701
NPI assigned
Jun 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS19041 FL Primary

Addresses

Primary practice location

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (855) 979-5700

Other practice location 1

395 W 27th St
Lumberton, NC 28358-3018
Phone (910) 739-7551

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
I20220709000689 FL Practitioner - Internal MedicinePractitioner - Hospitalist 4183950793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000

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

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

9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-5000

Hospital & facility affiliations

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Internal Medicine CurrentSince Aug 16, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Aug 16, 2022 Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

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

2675 Winkler Ave
Ste 2
Fort Myers, FL 33901

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

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jean-paul.alishahi.1@4290.direct.athenahealth.com

Organizations & group practices 2

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1124686118",
    "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": "855-979-5700",
            "fax_number": "855-979-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "855-979-5700",
            "fax_number": "855-979-5701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 27th St",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283583018",
            "country_code": "US",
            "telephone_number": "910-739-7551",
            "fax_number": "910-739-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALISHAHI",
        "first_name": "JEAN-PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS19041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.