Individual provider Active NPI

Anyeri Kania Peguero, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1134431463
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME116064 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP02092 RI
Internal Medicine Physician 207R00000X ME116064 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other identifiers 1

IdentifierTypeStateIssuer
008996900MedicaidFL

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
I20130712000257 FL Practitioner - Internal MedicinePractitioner - Nephrology 0941440077 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
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)

636 Del Prado Blvd S
Cape Coral, FL 33990-2668
Phone (239) 424-3513

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • 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
LP02092RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Mar 1, 2022 Accepting new patients
Cape Coral Hospitalists Inc Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Internal Medicine CurrentSince Mar 1, 2022 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

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

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

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: apeguero94523@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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1134431463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGUERO",
        "first_name": "ANYERI",
        "middle_name": "KANIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP02092",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008996900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.