Individual provider Active NPI

Bassan Jorge Allan

  • Surgical Oncology Physician
  • Fort Myers, FL
National Provider Identifier
1356582381
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
ME111167 Issued in FL
Practice address
8925 Colonial Center Dr Ste 1000
Fort Myers, FL 33905-7813
Phone
(239) 343-7400
Fax
(239) 468-7942
NPI assigned
Mar 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X ME111167 FL Primary

Addresses

Primary practice location

8925 Colonial Center Dr Ste 1000
Fort Myers, FL 33905-7813

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (393) 437-4002

Other practice location 1

4571 Colonial Blvd Ste 100
Fort Myers, FL 33966
Phone (239) 333-0995

Other identifiers 1

IdentifierTypeStateIssuer
025065300MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ballan114753@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912003637 FL Practitioner - Surgical OncologyPractitioner - General Surgery 2769732759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Tufts University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

8925 Colonial Ctr Dr
Suite 2001
Fort Myers, FL 33905-7813
Phone (239) 343-9567

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision41
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Jan 1, 2025 Accepting new patients
Lee Health System Inc CurrentSince Jan 1, 2025 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Jul 30, 2018 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Jul 30, 2018 Accepting new patients
Genesiscare USA of Florida LLC Surgical Oncology Current Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

4571 Colonial Blvd
Ste 110
Fort Myers, FL 33966
Phone (239) 226-2727

4571 Colonial Blvd
Ste 100
Fort Myers, FL 33966
Phone (239) 333-0995

8925 Colonial Center Dr
Ste 1000
Fort Myers, FL 33905
Phone (239) 343-9560

7335 Gladiolus Dr
Fort Myers, FL 33908
Phone (239) 689-6677

2160 Colonial Blvd
Fort Myers, FL 33907

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8925 Colonial Center Dr
Ste 2001
Fort Myers, FL 33905
Phone (239) 343-9567

8925 Colonial Center Dr
Ste 2000
Fort Myers, FL 33905
Phone (239) 333-0995

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ballan114753@direct.leememorial.org

Organizations & group practices 5

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 4

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": "1237593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1356582381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "393-437-4002",
            "fax_number": "239-468-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 COLONIAL CENTER DR STE 1000",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057813",
            "telephone_number": "239-343-7400",
            "fax_number": "239-468-7942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4571 Colonial Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "33966",
            "country_code": "US",
            "telephone_number": "239-333-0995",
            "fax_number": "844-615-5267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLAN",
        "first_name": "BASSAN",
        "middle_name": "JORGE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-21",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME111167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025065300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ballan114753@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.