Individual provider Active NPI

Sydney Lee Notermann, MD

  • Pediatrics Physician
  • Port Charlotte, FL
National Provider Identifier
1407506041
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME182143 Issued in FL
Practice address
22655 Bayshore Rd Ste 120
Port Charlotte, FL 33980-2005
Phone
(941) 235-4920
Fax
(239) 468-7935
NPI assigned
Mar 26, 2022
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 79946 MN
Pediatrics Physician 208000000X ME182143 FL Primary

Addresses

Primary practice location

22655 Bayshore Rd Ste 120
Port Charlotte, FL 33980-2005

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (941) 235-4920

Other practice location 1

3955 Parklawn Ave Ste 120
Edina, MN 55435-5660
Phone (952) 278-7000

Other identifiers 1

IdentifierTypeStateIssuer
131697700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address snotermann717443@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220622003324 MN Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6901285832

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79946MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southdale Pediatric Associates, LTD CurrentSince Sep 14, 2025 Accepting new patients

Locations

501 E Nicollet Blvd
Ste 200
Burnsville, MN 55337
Phone (952) 278-7000

11095 Viking Dr
Ste 250
Eden Prairie, MN 55344
Phone (952) 278-7000

3955 Parklawn Ave
Ste 120
Minneapolis, MN 55435
Phone (952) 278-7000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1407506041",
    "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": "941-235-4920",
            "fax_number": "239-468-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22655 BAYSHORE RD STE 120",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339802005",
            "telephone_number": "941-235-4920",
            "fax_number": "239-468-7935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3955 Parklawn Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554355660",
            "country_code": "US",
            "telephone_number": "952-278-7000",
            "fax_number": "952-278-6942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOTERMANN",
        "first_name": "SYDNEY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-26",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "79946",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME182143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131697700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snotermann717443@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 Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.