Individual provider Active NPI

Manuel A. Pardo, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Myers, FL
National Provider Identifier
1376583294
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME49556 Issued in FL
Practice address
42 Barkley Cir
Suite, 2
Fort Myers, FL 33907-4543
Phone
(239) 728-3500
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME49556 FL Primary

Addresses

Primary practice location

42 Barkley Cir
Suite, 2
Fort Myers, FL 33907-4543

Mailing address

42 Barkley Cir
Suite # 2
Fort Myers, FL 33907-4543

Other identifiers 1

IdentifierTypeStateIssuer
0420662-00MedicaidFL

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
I20040115000022 FL Practitioner - Endocrinology 9032010947 Reassigns benefits to 1 organization
Practice locations: Fort Myers, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME49556FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Myers Internal Medicine LLC CurrentSince Jul 5, 2016 Accepting new patients
Manuel a. Pardo, M.D. Endocrinology, Diabetes & Metabolism PastSince Jan 1, 1990 Accepting new patients
Schwartz and Schwartz Mdpa Past Accepting new patients
Associates in Neurological Care of Lee County Past Accepting new patients

Locations

13861 Plantation Rd
Ste 104
Fort Myers, FL 33912
Phone (239) 225-1306

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5830/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1376583294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BARKLEY CIR",
            "address_2": "SUITE # 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 BARKLEY CIR",
            "address_2": "SUITE, 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074543",
            "telephone_number": "239-728-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO",
        "first_name": "MANUEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME49556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420662-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.