Individual provider Active NPI

Davek Sharma, MD

  • Plastic and Reconstructive Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1255786943
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME1695888 Issued in FL
Practice address
12640 Creekside LN
Fort Myers, FL 33919-3359
Phone
(239) 482-7676
NPI assigned
Apr 29, 2016
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X ME1695888 FL Primary

Addresses

Primary practice location

12640 Creekside LN
Fort Myers, FL 33919-3359

Mailing address

10090 McGregor Blvd
Fort Myers, FL 33919-1039
Phone (239) 834-3192

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
I20240927001376 FL Practitioner - Plastic and Reconstructive Surgery 7113218561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Florida International Univ, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph F Mazza Jr MD PAGroup PAC ID 9234103458, 2 clinicians

Practice addresses (Care Compare)

12640 Creekside LN
Fort Myers, FL 33919-3359
Phone (239) 482-7676

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME1695888FLMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph F Mazza Jr MD PA CurrentSince Sep 1, 2024 Accepting new patients

Locations

12640 Creekside Ln
Fort Myers, FL 33919
Phone (239) 415-7576

Interoperability endpoints

  • Direct secure messaging: dsharma2694810@direct.trinity-health.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1255786943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10090 MCGREGOR BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191039",
            "telephone_number": "239-834-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 CREEKSIDE LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193359",
            "telephone_number": "239-482-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "DAVEK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME1695888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.