Individual provider Active NPI

Diana Marion Sitar, DO

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1174020085
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS18192 Issued in FL
Practice address
9345 Ben C Pratt/6 Mile Cypress Pkwy Ste 125
Fort Myers, FL 33966-6202
Phone
(239) 320-8145
Fax
(239) 320-8146
NPI assigned
Apr 7, 2018
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS18192 FL Primary

Addresses

Primary practice location

9345 Ben C Pratt/6 Mile Cypress Pkwy Ste 125
Fort Myers, FL 33966-6202

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

2780 Cleveland Ave Ste 709
Fort Myers, FL 33901-5857
Phone (239) 343-2551

Other identifiers 1

IdentifierTypeStateIssuer
OS18192OtherFLLICENSE

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
I20211103003205 FL Practitioner - Family Practice 1355739798 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS18192FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Hope Hospice and Community Services, Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Dec 1, 2021 Accepting new patients

Locations

10201 Arcos Ave
Ste 105
Estero, FL 33928
Phone (239) 333-2273

16131 Roserush Ct
Fort Myers, FL 33908
Phone (239) 343-7300

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

9345 Ben C Pratt/6 Mile Cypress Pkwy
Ste 125
Fort Myers, FL 33966
Phone (239) 320-8145

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

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1174020085",
    "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": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9345 BEN C PRATT/6 MILE CYPRESS PKWY STE 125",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339666202",
            "telephone_number": "239-320-8145",
            "fax_number": "239-320-8146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Cleveland Ave Ste 709",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015857",
            "country_code": "US",
            "telephone_number": "239-343-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SITAR",
        "first_name": "DIANA",
        "middle_name": "MARION",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS18192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OS18192",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.