Individual provider Active NPI

Edmundo Barreto, APRN

  • Family Nurse Practitioner
  • Lehigh Acres, FL
National Provider Identifier
1346909421
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11016985 Issued in FL
Practice address
615 Williams Ave
Lehigh Acres, FL 33972-7954
Phone
(239) 310-5269
NPI assigned
Dec 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11016985 FL Primary

Addresses

Primary practice location

615 Williams Ave
Lehigh Acres, FL 33972-7954

Mailing address

615 Williams Ave
Lehigh Acres, FL 33972-7954
Phone (239) 310-5269

Other practice location 1

13691 Metropolis Ave
Fort Myers, FL 33912-4318
Phone (239) 561-3376

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
I20220815001285 FL Practitioner - Nurse Practitioner 9032592613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

4037 Del Prado Blvd S
Advanced Dermatology and Cosmetic S
Cape Coral, FL 33904-7162
Phone (239) 308-0688

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016985FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Aug 1, 2022 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

1905 Clint Moore Rd
Ste 103
Boca Raton, FL 33496
Phone (561) 241-4474

4037 Del Prado Blvd S
Cape Coral, FL 33904
Phone (239) 561-3376

615 Williams Ave
Lehigh Acres, FL 33972
Phone (239) 260-9346

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

13691 Metropolis Ave
South Fort Myers, FL 33912
Phone (239) 208-5404

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1346909421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WILLIAMS AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727954",
            "telephone_number": "239-310-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WILLIAMS AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727954",
            "telephone_number": "239-310-5269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13691 Metropolis Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124318",
            "country_code": "US",
            "telephone_number": "239-561-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRETO",
        "first_name": "EDMUNDO",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-15",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11016985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.