Individual provider Active NPI

Fernando Estrada Baeza

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1265900336
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111765 Issued in FL
Practice address
13685 Doctors Way Ste 350
Fort Myers, FL 33912-4347
Phone
(239) 343-3800
Fax
(239) 343-3993
NPI assigned
Nov 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111765 FL Primary

Addresses

Primary practice location

13685 Doctors Way Ste 350
Fort Myers, FL 33912-4347

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-3800

Other practice location 1

2780 Cleveland Ave Ste 819
Fort Myers, FL 33901-5817
Phone (239) 343-3800

Other identifiers 1

IdentifierTypeStateIssuer
101459200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address festradabaeza123236@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181218000991 FL Practitioner - Physician Assistant 8820333990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
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

13685 Doctors Way
Fort Myers, FL 33912-4347

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111765FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Nov 19, 2018 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Nov 19, 2018 Accepting new patients

Locations

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

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

13685 Doctors Way
Ste 350
Fort Myers, FL 33912
Phone (239) 343-1000

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

2780 Cleveland Ave
Ste 819
Fort Myers, FL 33901
Phone (239) 336-6800

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

2780 Cleveland Ave
Ste 811
Fort Myers, FL 33901
Phone (239) 343-3800

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: festradabaeza123236@direct.leememorial.org

Organizations & group practices 4

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": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1265900336",
    "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": "239-343-3800",
            "fax_number": "239-343-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13685 DOCTORS WAY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124347",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Cleveland Ave Ste 819",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015817",
            "country_code": "US",
            "telephone_number": "239-343-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA BAEZA",
        "first_name": "FERNANDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101459200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "festradabaeza123236@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 Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.