NPIMap

Organization Active NPI

Anthony J. Williamitis M D Inc.

  • Family Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1164771069
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0049884 Issued in FL
Legal business name
ANTHONY J. WILLIAMITIS M D INC.
Practice address
9200 Bonita Beach Rd SE
#105
Bonita Springs, FL 34135-4280
Phone
(239) 947-6808
Fax
(239) 947-9625
NPI assigned
Sep 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Authorized official

Name
Dr. Anthony J Williamitis, M.D.NPI 1033289103
Title
President
Phone
(239) 947-6808

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME0049884 FL Primary

Addresses

Primary practice location

9200 Bonita Beach Rd SE
#105
Bonita Springs, FL 34135-4280

Mailing address

9200 Bonita Beach Rd SE
#105
Bonita Springs, FL 34135-4280
Phone (239) 947-6808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120910000847 FL Part B Supplier - Clinic/Group Practice 1052569407 Receives reassigned benefits from 12 practitioners
Practice locations: Bonita Springs, FL; Fort Myers, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2215630Anthony J Williamitis9200 Bonita Beach Road, Suite 105, Bonita Springs, FL 34135Certificate of waiverMar 4, 2027

National Provider Directory

National Provider Directory

Locations

9200 Bonita Beach Rd SE
Ste 105
Bonita Springs, FL 34135
Phone (239) 947-6808

3900 Broadway
Ste A1
Fort Myers, FL 33901
Phone (239) 288-5413

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16160/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1164771069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE",
            "address_2": "#105",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354280",
            "telephone_number": "239-947-6808",
            "fax_number": "239-947-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE",
            "address_2": "#105",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354280",
            "telephone_number": "239-947-6808",
            "fax_number": "239-947-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J. WILLIAMITIS M D INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMITIS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-947-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0049884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.