Individual provider Active NPI

Gary D. Josephson, MD

  • Otolaryngology Physician
  • Fort Myers, FL
National Provider Identifier
1144231671
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME73739 Issued in FL
Practice address
16410 Healthpark Commons Dr
Fort Myers, FL 33908-9621
Phone
(239) 343-7474
Fax
(239) 343-4190
NPI assigned
Aug 10, 2006
Last updated
Feb 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME73739 FL Primary
Pediatric Otolaryngology Physician 207YP0228X ME73739 FL

Addresses

Primary practice location

16410 Healthpark Commons Dr
Fort Myers, FL 33908-9621

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-7474

Other practice location 1

807 Childrens Way
Jacksonville, FL 32207-8426
Phone (904) 390-3690

Other identifiers 2

IdentifierTypeStateIssuer
000870504AMedicaidGA
252814201MedicaidFL

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
I20100318000861 FL Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 6103951934 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Otolaryngology CurrentSince Feb 5, 2024 Accepting new patients
The Nemours Foundation CurrentSince Dec 22, 2009 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Dec 22, 2009 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Otolaryngology CurrentSince Feb 5, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Current Accepting new patients

Locations

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

16410 Healthpark Commons Dr
Fort Myers, FL 33908

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

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

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

Interoperability endpoints

  • Direct secure messaging: gjosephson382439@direct.leememorial.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1144231671",
    "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": "239-343-7474",
            "fax_number": "239-343-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 HEALTHPARK COMMONS DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089621",
            "telephone_number": "239-343-7474",
            "fax_number": "239-343-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "country_code": "US",
            "telephone_number": "904-390-3690",
            "fax_number": "904-390-3502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPHSON",
        "first_name": "GARY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME73739",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME73739",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000870504A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252814201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.