Individual provider Active NPI

Iasmina Jivanov, M.D.

  • Internal Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1265782247
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME120026 Issued in FL
Practice address
224 Santa Barbara Blvd Ste 102
Cape Coral, FL 33991-2038
Phone
(239) 424-1900
Fax
(239) 424-1908
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME120026 FL
Internal Medicine Physician 207R00000X ME120026 FL Primary
Internal Medicine Physician 207R00000X 267293 NY

Addresses

Primary practice location

224 Santa Barbara Blvd Ste 102
Cape Coral, FL 33991-2038

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1900

Other practice location 1

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 424-1449

Other practice location 2

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 424-1449

Other practice location 3

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 343-2052

Other identifiers 1

IdentifierTypeStateIssuer
014264400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ijivanov89414@Direct.leememorial.org Lee Memorial Health System

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
I20150217001939 FL Practitioner - HospitalistPractitioner - Internal Medicine 0840438800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2003
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

224 Santa Barbara Blvd
Cape Coral, FL 33991-2038

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME120026FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 1, 2015 Accepting new patients
Lee Memorial Health System Internal Medicine Current Accepting new patients
Wyckoff Medical Services, P C Internal Medicine Past Accepting new patients

Locations

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

224 Santa Barbara Blvd
Ste 205
Cape Coral, FL 33991
Phone (239) 424-1400

224 Santa Barbara Blvd
Ste 102
Cape Coral, FL 33991
Phone (239) 424-1900

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

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

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

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

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

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ijivanov89414@direct.leememorial.org

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 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": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1265782247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1900",
            "fax_number": "239-424-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SANTA BARBARA BLVD STE 102",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912038",
            "telephone_number": "239-424-1900",
            "fax_number": "239-424-1908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2776 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015864",
            "country_code": "US",
            "telephone_number": "239-424-1449",
            "fax_number": "239-424-1421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2776 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015864",
            "country_code": "US",
            "telephone_number": "239-424-1449",
            "fax_number": "239-424-1421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9981 S Healthpark Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "33908",
            "country_code": "US",
            "telephone_number": "239-343-2052",
            "fax_number": "239-343-5348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIVANOV",
        "first_name": "IASMINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME120026",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME120026",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267293",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014264400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ijivanov89414@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.