Individual provider Active NPI

Debra Lee Sicilian, APRN

  • Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1386101798
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11001584 Issued in FL
Practice address
2327 Jeffcott St
Fort Myers, FL 33901-5211
Phone
(239) 246-8967
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11001584 FL Primary

Addresses

Primary practice location

2327 Jeffcott St
Fort Myers, FL 33901-5211

Mailing address

58 Deforest Dr
N Branford, CT 06471-1258
Phone (239) 246-8967

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20191004000406 CT Practitioner - Nurse Practitioner 9638400799 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001584FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Behavioral Health Assoc, P.C. CurrentSince Sep 24, 2023 Accepting new patients
Impact Health Psych PC CurrentSince Oct 1, 2020 Accepting new patients
Harvest Healthcare LLC Nurse Practitioner CurrentSince Jun 15, 2021 Accepting new patients
Impact Health P.C. Nurse Practitioner CurrentSince Sep 23, 2019 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

2969 Whitney Ave
Hamden, CT 06518
Phone (203) 691-7634

41 Faire Harbour Pl
New London, CT 06320
Phone (860) 437-6914

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

240 Indian River Rd
Ste C7
Orange, CT 06477
Phone (203) 497-3867

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": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1386101798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 DEFOREST DR",
            "city": "N BRANFORD",
            "state": "CT",
            "postal_code": "064711258",
            "telephone_number": "239-246-8967",
            "fax_number": "203-742-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 JEFFCOTT ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015211",
            "telephone_number": "239-246-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIAN",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11001584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.