Individual provider Active NPI

Michael Leonard Emery, PA-C

  • Medical Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1215699319
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
14192 Metropolis Ave
Fort Myers, FL 33912-4331
Phone
(239) 245-8223
NPI assigned
Oct 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

14192 Metropolis Ave
Fort Myers, FL 33912-4331

Mailing address

4562 Winkler Ave Apt 106
Fort Myers, FL 33966-7021
Phone (954) 534-1459

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
I20211015001434 FL Practitioner - Physician Assistant 4688072077 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Healthcare Specialists, LLCGroup PAC ID 6103284955, 129 clinicians

Practice addresses (Care Compare)

13691 Metro Pkwy
Suite 300
Fort Myers, FL 33912-4322
Phone (239) 291-6970

1685 Tamiami TRL
BLDG 4
Port Charlotte, FL 33948-1042
Phone (239) 374-5220

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Jan 6, 2022 Accepting new patients
Millennium Physician Group LLC CurrentSince Jan 6, 2022 Accepting new patients
SK Raman PA Past Accepting new patients

Locations

6321 Daniels Pkwy
Ste 200
Fort Myers, FL 33912
Phone (855) 674-7400

13691 Metro Pkwy
Ste 300
Fort Myers, FL 33912
Phone (239) 291-6970

1685 Tamiami Trl
Bldg 4
Pt Charlotte, FL 33948
Phone (239) 374-5220

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1215699319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4562 WINKLER AVE APT 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339667021",
            "telephone_number": "954-534-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14192 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124331",
            "telephone_number": "239-245-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERY",
        "first_name": "MICHAEL",
        "middle_name": "LEONARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.