Individual provider Active NPI

Martha Barzana-Fernandez

  • Internal Medicine Physician
  • Estero, FL
National Provider Identifier
1184017782
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15202 Issued in FL
Practice address
23450 Via Coconut PT
Estero, FL 34135
Phone
(239) 468-0150
Fax
(239) 343-4056
NPI assigned
Mar 6, 2015
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS15202 FL Primary

Addresses

Primary practice location

23450 Via Coconut PT
Estero, FL 34135

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 468-0150

Other practice location 1

2001 W 68th St
Hialeah, FL 33016-1801
Phone (305) 364-2107

Other identifiers 1

IdentifierTypeStateIssuer
101947800MedicaidFL

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
I20180918000638 FL Practitioner - Internal Medicine 8426345521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidewell Sanitas I, LLCGroup PAC ID 9537447107, 124 clinicians

Practice addresses (Care Compare)

15600 NW 67TH Ave
Suite 301
Miami Lakes, FL 33014-2176
Phone (844) 665-4827

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15202FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Dade Primary Care, LLC Internal Medicine CurrentSince Dec 6, 2021 Accepting new patients

Locations

1000 NW 57th Ct
Ste 400
Miami, FL 33126

14750 NW 77th Ct
Ste 100
Miami Lakes, FL 33016
Phone (786) 485-1005

9835 E Hibiscus St
Palmetto Bay, FL 33157
Phone (305) 238-8561

5901 SW 74th St
Ste 205
South Miami, FL 33143
Phone (305) 666-8691

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15805/brand/1/csg/1/fhir/r4
  • Direct secure messaging: martha.barzanafernandez@wwmp.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1184017782",
    "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": "239-468-0150",
            "fax_number": "239-343-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23450 VIA COCONUT PT",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "34135",
            "telephone_number": "239-468-0150",
            "fax_number": "239-343-4056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 W 68th St",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330161801",
            "country_code": "US",
            "telephone_number": "305-364-2107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARZANA-FERNANDEZ",
        "first_name": "MARTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-06",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101947800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

Verify at the official NPI Registry.