Organization Active NPI

Naples Interventional Cardiac Electrophysiology, LLC

  • Clinical Cardiac Electrophysiology Physician
  • Naples, FL
National Provider Identifier
1205891645
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
Legal business name
NAPLES INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, LLC
Practice address
6609 Willow Park Dr Ste 100
Naples, FL 34109-9015
Phone
(239) 643-9977
Fax
(239) 596-2743
NPI assigned
Apr 19, 2006
Last updated
Jan 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Dr. A. Sinan Gursoy, M.D.
Title
Partner
Phone
(239) 643-9977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU Primary

Addresses

Primary practice location

6609 Willow Park Dr Ste 100
Naples, FL 34109-9015

Mailing address

6609 Willow Park Dr Ste 100
Naples, FL 34109-9015
Phone (239) 643-9977

Other identifiers 3

IdentifierTypeStateIssuer
DD0516OtherFLMCR RR
38388OtherFLBCBS
270364500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020000754 FL Part B Supplier - Clinic/Group Practice 4385605674 Receives reassigned benefits from 5 practitioners
Practice locations: Naples, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1020549Naples Interventional Cardiac Electrophysiology6609 Willow Park Dr - Ste 100, Naples, FL 34109Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory

Locations

311 Tamiami Trl N
Ste 201
Naples, FL 34102
Phone (239) 624-0030

6609 Willow Park Dr
Ste 100
Naples, FL 34109
Phone (239) 643-9977

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1205891645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 WILLOW PARK DR STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099015",
            "telephone_number": "239-643-9977",
            "fax_number": "239-643-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 WILLOW PARK DR STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099015",
            "telephone_number": "239-643-9977",
            "fax_number": "239-596-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAPLES INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "GURSOY",
        "authorized_official_first_name": "A. SINAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "239-643-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RR",
            "identifier": "DD0516",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38388",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270364500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.