Individual provider Active NPI

Sheeja A Kanacheril, D.O.

  • Family Medicine Physician
  • Lehigh Acres, FL
National Provider Identifier
1275756603
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS10092 Issued in FL
Practice address
1530 Lee Blvd
Suite 1100
Lehigh Acres, FL 33936-4893
Phone
(239) 368-0241
Fax
(239) 368-0398
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS10092 FL Primary

Addresses

Primary practice location

1530 Lee Blvd
Suite 1100
Lehigh Acres, FL 33936-4893

Mailing address

1530 Lee Blvd
Suite 1100
Lehigh Acres, FL 33936-4893
Phone (239) 368-0241

Other identifiers 5

IdentifierTypeStateIssuer
278616800MedicaidFL
46017OtherFLBLUE CROSS
325319OtherFLAETNA
390683OtherFLWELLCARE
325319OtherFLAMERIGROUP

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
I20250702003173 FL Practitioner - Family Practice 7416044029 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Hospice and Community Services, Inc Family Medicine CurrentSince Jun 1, 2025 Accepting new patients

Locations

9470 Healthpark Cir
Fort Myers, FL 33908
Phone (239) 433-8073

16131 Roserush Ct
Fort Myers, FL 33908
Phone (239) 343-7300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1275756603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 LEE BLVD",
            "address_2": "SUITE 1100",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364893",
            "telephone_number": "239-368-0241",
            "fax_number": "239-368-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LEE BLVD",
            "address_2": "SUITE 1100",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364893",
            "telephone_number": "239-368-0241",
            "fax_number": "239-368-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANACHERIL",
        "first_name": "SHEEJA",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278616800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "46017",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "325319",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "390683",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "325319",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.