Individual provider Active NPI

Evan Kamperman, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1225324767
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME119744 Issued in FL
Practice address
1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone
(904) 396-6620
Fax
(904) 396-6528
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP02313 RI
Internal Medicine Physician 207R00000X ME119744 FL Primary

Addresses

Primary practice location

1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046

Mailing address

1200 Riverplace Blvd
Suite 620
Jacksonville, FL 32207-9046
Phone (904) 396-6620

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805000530 FL Practitioner - Internal Medicine 7315186038 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine Current Accepting new patients
Lee Memorial Health System Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Jan 29, 2015 Accepting new patients
Lee Health System Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Cape Coral Hospitalists Inc Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Jan 29, 2015 Accepting new patients
Lee Memorial Health System CurrentSince Mar 1, 2022 Accepting new patients

Locations

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

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

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

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

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

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

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

1200 Riverplace Blvd
Ste 620
Jacksonville, FL 32207
Phone (904) 396-6620

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ekamperman94524@direct.leememorial.org

Organizations & group practices 8

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 3

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1225324767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMPERMAN",
        "first_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP02313",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME119744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.