Individual provider Active NPI

Richard Michael Daum, MD

  • Cardiovascular Disease Physician
  • Fort Myers, FL
National Provider Identifier
1265482061
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
112568 Issued in FL
Practice address
13411 Parker Commons Blvd Ste 101
Fort Myers, FL 33912-1873
Phone
(239) 415-4900
Fax
(239) 337-4901
NPI assigned
May 11, 2006
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME112568 FL
Cardiovascular Disease Physician 207RC0000X 112568 FL Primary

Addresses

Primary practice location

13411 Parker Commons Blvd Ste 101
Fort Myers, FL 33912-1873

Mailing address

13411 Parker Commons Blvd Ste 101
Fort Myers, FL 33912-1873
Phone (239) 415-4900

Other practice location 1

708 Del Prado Blvd S
Ste 7
Cape Coral, FL 33990
Phone (239) 424-3660

Other identifiers 2

IdentifierTypeStateIssuer
14K5LOtherFLORIDA BLUE
005571400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address richard.daum@ccswf.eclinicaldirect.com Direct

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
I20120608000202 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3476500117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
80.05
Improvement activities
40
Cost
74.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112568FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Consultants of Southwest Florida, Inc. Cardiovascular Disease CurrentSince Jan 11, 2021 Accepting new patients
Oconee Medical Center Past Accepting new patients
Concord Ekg Associates Cardiovascular Disease Past Accepting new patients

Locations

13411 Parker Commons Blvd
Ste 101
Fort Myers, FL 33912
Phone (239) 415-4900

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1265482061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13411 PARKER COMMONS BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121873",
            "telephone_number": "239-415-4900",
            "fax_number": "239-337-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13411 PARKER COMMONS BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121873",
            "telephone_number": "239-415-4900",
            "fax_number": "239-337-4901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 DEL PRADO BLVD S",
            "address_2": "STE 7",
            "address_purpose": "LOCATION",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "country_code": "US",
            "telephone_number": "239-424-3660",
            "fax_number": "239-424-3663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUM",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME112568",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "112568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "14K5L",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005571400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.daum@ccswf.eclinicaldirect.com",
            "affiliation": "N",
            "endpointDescription": "eClinicalWorks",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13411 Parker Commons Blvd Ste 101",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339121873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.