NPIMap

Individual provider Active NPI

Mila Kmezic, M.D.

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1154707065
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME158572 Issued in FL
Practice address
1569 Matthew Dr
Fort Myers, FL 33907-1734
Phone
(239) 343-8200
Fax
(239) 343-8221
NPI assigned
Aug 3, 2015
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125.066470 IL
Internal Medicine Physician 207R00000X 036-144539 IL
Internal Medicine Physician 207R00000X ME158572 FL Primary

Addresses

Primary practice location

1569 Matthew Dr
Fort Myers, FL 33907-1734

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-8220

Other identifiers 1

IdentifierTypeStateIssuer
116214800MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkmezic313363@Direct.leememorial.org Direct Lee Memorial Health System
Direct Messaging Address mila.kmezic@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230124001208 FL Practitioner - Internal Medicine 5395000277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

1569 Matthew Dr
Fort Myers, FL 33907-1734
Phone (239) 343-8220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME158572FLMDInternal Medicine Physician
036-144539ILMDInternal Medicine Physician
125.066470ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Jan 16, 2023 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Jan 16, 2023 Accepting new patients
Lee Health System Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Internal Medicine Current Accepting new patients

Locations

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

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

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

Interoperability endpoints

  • Direct secure messaging: mila.kmezic@direct.genesishealth.com
  • Direct secure messaging: mkmezic313363@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1154707065",
    "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": "239-343-8220",
            "fax_number": "239-343-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 MATTHEW DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071734",
            "telephone_number": "239-343-8200",
            "fax_number": "239-343-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KMEZIC",
        "first_name": "MILA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.066470",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-144539",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME158572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116214800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkmezic313363@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mila.kmezic@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "genesis health system direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccda",
            "address_1": "1007 NW 3rd St",
            "city": "Aledo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612311317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.