Active NPI
Hazel-Ann Prince-Wannah, MD
- Hospitalist Physician
- Brooklyn, NY
National Provider Identifier
1407590698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- ME174995
- Practice address
- 450 Clarkson Avenue
Dept of Medicine
Brooklyn, NY 11203-2012 - Phone
- (718) 245-3408
- NPI assigned
- Apr 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | ME174995 | FL | Primary |
Addresses
Primary practice location
450 Clarkson Avenue
Dept of Medicine
Brooklyn, NY 11203-2012
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-2052
Other practice location 1
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-2052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127956000 | Medicaid | FL |
Other names 1
- Dr. Hazel-Ann Prince
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hprincewannah679447@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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-2606
Hospital & facility affiliations
- Lee Memorial Hospital
- Gulf Coast Medical Center Lee Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- hprincewannah679447@direct.leememorial.org
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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1366281750
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1427806025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757462400000",
"number": "1407590698",
"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": "239-343-2052",
"fax_number": "239-343-5348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 CLARKSON AVENUE",
"address_2": "DEPT OF MEDICINE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032012",
"telephone_number": "718-245-3408"
}
],
"practiceLocations": [
{
"address_1": "9981 S Healthpark Dr",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339083618",
"country_code": "US",
"telephone_number": "239-343-2052",
"fax_number": "239-343-5348",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRINCE-WANNAH",
"first_name": "HAZEL-ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-24",
"last_updated": "2025-09-10",
"certification_date": "2025-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "ME174995",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "127956000",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hprincewannah679447@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": [
{
"first_name": "HAZEL-ANN",
"last_name": "PRINCE",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.