Individual provider Active NPI

Martin F. Nicolau, MD

  • Hematology & Oncology Physician
  • Bonita Springs, FL
National Provider Identifier
1295718070
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME80435 Issued in FL
Practice address
9776 Bonita Beach Rd SE
#201A
Bonita Springs, FL 34135-4773
Phone
(239) 947-3092
Fax
(239) 947-1077
NPI assigned
Nov 25, 2005
Last updated
Sep 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME80435 FL Primary

Addresses

Primary practice location

9776 Bonita Beach Rd SE
#201A
Bonita Springs, FL 34135-4773

Mailing address

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916-2216
Phone (239) 274-8200

Other identifiers 2

IdentifierTypeStateIssuer
830006897OtherFLRR MEDICARE
259862100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME80435FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Hematology & Oncology CurrentSince Nov 28, 2005 Accepting new patients

Locations

9776 Bonita Beach Rd SE
Ste 201A
Bonita Springs, FL 34135
Phone (239) 947-3092

2890 Center Pointe Dr
Fort Myers, FL 33916

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1295718070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 BONITA BEACH RD SE",
            "address_2": "#201A",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354773",
            "telephone_number": "239-947-3092",
            "fax_number": "239-947-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAU",
        "first_name": "MARTIN",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME80435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "830006897",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259862100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.