Individual provider Active NPI

Holly Schisani, D.O.

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1184072233
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15568 Issued in FL
Practice address
3822 Broadway
Fort Myers, FL 33901-8148
Phone
(239) 248-0187
NPI assigned
May 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS15568 FL
Internal Medicine Physician 207R00000X OS15568 FL Primary

Addresses

Primary practice location

3822 Broadway
Fort Myers, FL 33901-8148

Mailing address

3036 Ellice Way
Naples, FL 34119-1604

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
I20190912000097 FL Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 7719216019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ballout International PLLCGroup PAC ID 5890045256, 48 clinicians

Practice addresses (Care Compare)

1931 19TH PL
Vero Beach, FL 32960-3555
Phone (321) 387-9451

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Myers Chiropractic & Nutrition Center, Inc. CurrentSince Jul 15, 2019 Accepting new patients
NH Medical Institute LLC Past Accepting new patients
Mdcare Health System, PLLC PastSince Dec 2, 2020 Accepting new patients
Sievert Clinic, LLC PastSince Mar 23, 2009 Accepting new patients

Locations

3800 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 936-1233

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1184072233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3036 ELLICE WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341191604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 BROADWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018148",
            "telephone_number": "239-248-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHISANI",
        "first_name": "HOLLY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS15568",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.