Individual provider Active NPI

Ivan Dankanich, ARNP

  • Primary Care Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1295182269
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP9249134 Issued in FL
Practice address
19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone
(941) 255-3535
NPI assigned
May 19, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP9249134 FL Primary

Addresses

Primary practice location

19531 Cochran Blvd
Port Charlotte, FL 33948-2081

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

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
I20170203000402 FL Practitioner - Nurse Practitioner 3870876592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Mar 28, 2022 Accepting new patients
Concierge Medicine of SWF, Inc Current Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 28, 2022 Accepting new patients
Florida Department of Health Current Accepting new patients
Florida Department of Health CurrentSince Dec 7, 2016 Accepting new patients
Florida Department of Health CurrentSince Dec 7, 2016 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

6950 Outreach Way
North Port, FL 34287
Phone (941) 529-0200

1912 Kings Hwy
Unit 700
Port Charlotte, FL 33980
Phone (941) 255-0032

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

2200 Ringling Blvd
Sarasota, FL 34237
Phone (941) 861-2900

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ivan.dankanich.1@4290.direct.athenahealth.com

Organizations & group practices 6

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1295182269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19531 COCHRAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482081",
            "telephone_number": "941-255-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANKANICH",
        "first_name": "IVAN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9249134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.