NPIMap

Organization Active NPI

Psychiatric Associates of Southwest Florida

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1225309552
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
PSYCHIATRIC ASSOCIATES OF SOUTHWEST FLORIDA
Practice address
6800 Porto Fino Cir
Fort Myers, FL 33912-7137
Phone
(239) 332-4700
Fax
(888) 769-5641
NPI assigned
Jan 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Hilary Sojdak, MSN APRN PMHNPNPI 1558657593
Title
Owner
Phone
(239) 332-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

6800 Porto Fino Cir
Fort Myers, FL 33912-7137

Mailing address

6800 Porto Fino Cir
Fort Myers, FL 33912-7137
Phone (239) 332-4700

Other practice location 1

6804 Porto Fino Cir
Fort Myers, FL 33912-7139
Phone (239) 332-4700

Other names 1

  • Psychiatric Associates of SW FL Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120207000094 FL Part B Supplier - Clinic/Group Practice 9638336423 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

6800 Porto Fino Cir
Fort Myers, FL 33912
Phone (239) 332-4700

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1225309552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PORTO FINO CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127137",
            "telephone_number": "239-332-4700",
            "fax_number": "888-769-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 PORTO FINO CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127137",
            "telephone_number": "239-332-4700",
            "fax_number": "888-769-5641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6804 Porto Fino Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339127139",
            "country_code": "US",
            "telephone_number": "239-332-4700",
            "fax_number": "888-769-5641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES OF SOUTHWEST FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "SOJDAK",
        "authorized_official_first_name": "HILARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-332-4700",
        "authorized_official_credential": "MSN APRN PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Associates of SW FL",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Psychiatric Associates of SW FL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.