Individual provider Active NPI

Aaron Bruce Walker, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1194472464
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115707 Issued in FL
Practice address
4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone
(239) 343-9800
Fax
(239) 343-9848
NPI assigned
Mar 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115707 FL Primary

Addresses

Primary practice location

4771 S Cleveland Ave
Fort Myers, FL 33907-1317

Mailing address

17276 Hidden Estates Cir
Fort Myers, FL 33908-5053
Phone (914) 213-4253

Other practice location 1

9241 Park Royal Dr
Fort Myers, FL 33908-9204
Phone (914) 213-4253

Other identifiers 1

IdentifierTypeStateIssuer
113982000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awalker299140@Direct.leememorial.org Direct Lee Memorial Health System

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220426001251 FL Practitioner - Physician Assistant 9032506837 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9115707FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Aug 15, 2022 Accepting new patients
Lee Memorial Health System CurrentSince Aug 15, 2022 Accepting new patients
Lee Health System Inc CurrentSince Feb 3, 2025 Accepting new patients
Lee Health System Inc CurrentSince Feb 3, 2025 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

4771 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9800

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: awalker299140@direct.leememorial.org

Organizations & group practices 6

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": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1194472464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17276 HIDDEN ESTATES CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085053",
            "telephone_number": "914-213-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 S CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071317",
            "telephone_number": "239-343-9800",
            "fax_number": "239-343-9848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9241 Park Royal Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339089204",
            "country_code": "US",
            "telephone_number": "914-213-4253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "AARON",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113982000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awalker299140@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.