Pedro Ylisastigui. M.D.P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME80423 Issued in FL

Legal business name

PEDRO YLISASTIGUI. M.D.P.A.

Practice address

1150 Lee Blvd Ste 4
Lehigh Acres, FL 33936-4805

Phone

(239) 369-9911

NPI assigned

Sep 21, 2010

Organization subpart

No

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

Authorized official

Name

Pedro Ylisastigui, M.D.NPI 1477610715

Title

President

Phone

(239) 369-9911

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7262/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pedro P Ylisastigui, M.D.

  • Internal Medicine Physician
  • Lehigh Acres, FL
  • NPI 1477610715
  Medicare reassignment NPD Authorized official
• Veronica Diaz, APRN

  • Family Nurse Practitioner
  • Fort Myers, FL
  • NPI 1811743123
  Medicare reassignment NPD
• Diorgis Torres Mondejar, FNP

  • Family Nurse Practitioner
  • Naples, FL
  • NPI 1518683077

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1295043552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 LEE BLVD STE 4",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364805",
            "telephone_number": "239-369-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 LEE BLVD STE 4",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364805",
            "telephone_number": "239-369-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDRO YLISASTIGUI. M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "YLISASTIGUI",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-369-9911",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259642300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erik Shane Pecore, PT ATC
• Pediatric Centers of Lee County
• Nickalea Pedley
• Elizabeth Pedregal, M.ED
• Daylin De la Caridad Pedrero Gonzalez
• Liriam Maria Pelaez Menendez
• Pelican Haven,LLC
• Pelican Pediatric Dentistry LLC
• Edel Raul Pena de la Cruz
• Thelma Lissette Pena Lozano

• Internal Medicine Physician in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.