Active NPI
Olga Porotin, PA
- Physician Assistant
- Fort Myers, FL
National Provider Identifier
1205909546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9112979
- Practice address
- 8925 Colonial Center Dr Ste 1000
Fort Myers, FL 33905-7813 - Phone
- (239) 343-9325
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9112979 | FL | Primary |
| Surgical Physician Assistant | 363AS0400X | 5573 | NY |
Addresses
Primary practice location
8925 Colonial Center Dr Ste 1000
Fort Myers, FL 33905-7813
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9325
Other practice location 1
270 Park Ave
Huntington, NY 11743-2787
Phone (631) 547-6392
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130649200 | Medicaid | FL | |
| 02073852 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oporotin711953@Direct.leememorial.org | Direct | LEE HEALTH SYSTEM INC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8925 Colonial Ctr Dr
Suite 1000
Fort Myers, FL 33905-7813
Phone (239) 343-9560
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9112979 | FL | MD | Physician Assistant |
| 5573 | NY | MD | Surgical Physician Assistant |
Interoperability endpoints
- oporotin711953@direct.leememorial.org
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778112000000",
"number": "1205909546",
"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": "239-343-9325",
"fax_number": "239-468-7950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8925 COLONIAL CENTER DR STE 1000",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339057813",
"telephone_number": "239-343-9325"
}
],
"practiceLocations": [
{
"address_1": "270 Park Ave",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "NY",
"postal_code": "117432787",
"country_code": "US",
"telephone_number": "631-547-6392",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POROTIN",
"first_name": "OLGA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9112979",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "5573",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130649200",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02073852",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "oporotin711953@Direct.leememorial.org",
"affiliation": "Y",
"affiliationName": "LEE HEALTH SYSTEM INC",
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.