Individual provider Active NPI

Robert James Summerlee, M.D.

  • Gastroenterology Physician
  • Bradenton, FL
National Provider Identifier
1174596050
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME118680 Issued in FL
Practice address
11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone
(941) 538-0092
Fax
(941) 538-0093
NPI assigned
Feb 10, 2006
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME118680 FL Primary

Addresses

Primary practice location

11715 Rangeland Pkwy
Bradenton, FL 34211-9529

Mailing address

11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone (941) 538-0092

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Robert.Summerlee@img.directbygreenway.com Direct

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
I20140811002164 FL Practitioner - Gastroenterology 2769610849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Miami, LM Miller School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone (941) 538-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy379
Upper gastrointestinal (GI) endoscopy for acid reflux438

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME118680FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients
Intercoastal Medical Group Inc CurrentSince Sep 23, 2021 Accepting new patients

Locations

11715 Rangeland Pkwy
Bradenton, FL 34211
Phone (941) 538-0001

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

Interoperability endpoints

  • Direct secure messaging: robert.summerlee@img.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70573

Organizations & group practices 2

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 3

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1174596050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11715 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119529",
            "telephone_number": "941-538-0092",
            "fax_number": "941-538-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119529",
            "telephone_number": "941-538-0092",
            "fax_number": "941-538-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERLEE",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME118680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Robert.Summerlee@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11715 Rangeland Pkwy",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342119529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.