Individual provider Active NPI

Anthony Cepero, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1285478644
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118823 Issued in FL
Practice address
3637 Dr Martin Luther King Blvd Ste 101
Fort Myers, FL 33916-4601
Phone
(239) 343-4910
Fax
(239) 343-4911
NPI assigned
Jun 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA9118823 FL Primary

Addresses

Primary practice location

3637 Dr Martin Luther King Blvd Ste 101
Fort Myers, FL 33916-4601

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-4910

Other practice location 1

17501 Shelby Ln
North Fort Myers, FL 33917-7030
Phone (239) 281-9222

Other identifiers 1

IdentifierTypeStateIssuer
123496100MedicaidFL

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
I20240816002779 FL Practitioner - Physician Assistant 1557809886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

13279 N Cleveland Ave
North Fort Myers, FL 33903-4818
Phone (239) 652-4111

4751 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9888

4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9800

Hospital & facility affiliations

  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Sep 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Jan 18, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Sep 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Jan 18, 2025 Accepting new patients

Locations

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

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

3637 Dr Martin Luther King Blvd
Unit 101
Fort Myers, FL 33916
Phone (239) 343-4910

13279 N Cleveland Ave
North Ft Myers, FL 33903
Phone (239) 424-2767

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: acepero410969@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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1285478644",
    "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": "239-343-4910",
            "fax_number": "239-343-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 DR MARTIN LUTHER KING BLVD STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339164601",
            "telephone_number": "239-343-4910",
            "fax_number": "239-343-4911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17501 Shelby Ln",
            "address_purpose": "LOCATION",
            "city": "North Fort Myers",
            "state": "FL",
            "postal_code": "339177030",
            "country_code": "US",
            "telephone_number": "239-281-9222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEPERO",
        "first_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123496100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.