Individual provider Active NPI

Blaise M Kovaz, M.D.

  • Obstetrics & Gynecology Physician
  • Fort Myers, FL
National Provider Identifier
1174505341
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME49497 Issued in FL
Practice address
9021 Park Royal Dr
Fort Myers, FL 33908-9617
Phone
(239) 432-5858
Fax
(239) 482-6297
NPI assigned
Nov 15, 2005
Last updated
Oct 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME49497 FL Primary

Addresses

Primary practice location

9021 Park Royal Dr
Fort Myers, FL 33908-9617

Mailing address

12730 New Brittany Blvd Ste 602
Fort Myers, FL 33907-4690
Phone (239) 275-5522

Other identifiers 5

IdentifierTypeStateIssuer
208742OtherFLAVMED
09415OtherFLBC/BS OF FLORIDA
371204400MedicaidFL
000011209MOtherFLHUMANA
15892OtherFLSTAYWELL

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
I20100408000232 FL Practitioner - Obstetrics/Gynecology 7810070802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Florida College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

9021 Park Royal Dr
Fort Myers, FL 33908-9617
Phone (239) 481-5437

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.69 of 100Reported as individual
Quality
84.9
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC Obstetrics & Gynecology CurrentSince Sep 1, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Womencare PA Past Accepting new patients

Locations

1501 W Yamato Rd
Ste 200
Boca Raton, FL 33431
Phone (561) 444-8298

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

1265 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 573-7337

3230 Forum Blvd
Fort Myers, FL 33905
Phone (239) 432-5858

9021 Park Royal Dr
Fort Myers, FL 33908
Phone (239) 432-5858

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: blaise.kovaz.1@2183.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1174505341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 NEW BRITTANY BLVD STE 602",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074690",
            "telephone_number": "239-275-5522",
            "fax_number": "239-275-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 PARK ROYAL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089617",
            "telephone_number": "239-432-5858",
            "fax_number": "239-482-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAZ",
        "first_name": "BLAISE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME49497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "208742",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF FLORIDA",
            "identifier": "09415",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371204400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "000011209M",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL",
            "identifier": "15892",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.