Nathaly Pachon

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

9119301 Issued in FL

Practice address

4571 Colonial Blvd Ste 110
Fort Myers, FL 33966-1156

Phone

(239) 790-3480

Fax

(239) 244-2049

NPI assigned

Jan 6, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida ENT Adult and Pediatric PAGroup PAC ID 3971532763, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGADAA

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.

• Florida ENT Adult & Pediatric PA

  • Otolaryngology Physician
  • Kissimmee, FL
  • NPI 1316908353
  Medicare reassignment Care Compare group NPD
• Florida ENT Adult & Pediatrics, PA

  • Medical Physician Assistant
  • Kissimmee, FL
  • NPI 1972905099
  NPD
• Genesiscare USA of Florida LLC

  • Medical Oncology Physician
  • Boynton Beach, FL
  • NPI 1386012615
  NPD
• Genesiscare USA of Florida LLC

  • Urology Physician
  • Boca Raton, FL
  • NPI 1649093709
  NPD
• Genesiscare USA of Florida LLC

  • Radiation Oncology Physician
  • Fort Myers, FL
  • NPI 1134109747
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridges Home Health Inc.

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1376517862
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1306655147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4571 COLONIAL BLVD STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4571 COLONIAL BLVD STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661156",
            "telephone_number": "239-790-3480",
            "fax_number": "239-244-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHON",
        "first_name": "NATHALY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9119301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernesto Antonio Pacheco Diaz, APRN
• Jose Cassini Pacheco, MD
• Luz E Pacheco, ARNP
• Naomi Pacheco, CNM
• Jacqueline Pachiva
• Eric M Pachter, MD
• Lydia Paciotti
• Victoria Packard
• Rebecca Jo Padavich (Hensley), RN
• Cameron Padgett, RN

• Surgical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.