Individual provider Active NPI

Brian W Hummel, MD.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Myers, FL
National Provider Identifier
1417999079
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME46159 Issued in FL
Practice address
9981 S Healthpark Dr Ste 156
Fort Myers, FL 33908-3618
Phone
(239) 343-6341
Fax
(239) 343-6342
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME46159 FL Primary

Addresses

Primary practice location

9981 S Healthpark Dr Ste 156
Fort Myers, FL 33908-3618

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6341

Other identifiers 6

IdentifierTypeStateIssuer
53818OtherFLBLUE SHIELD
ME46159OtherFLMEDICAL LICENSE
3568049OtherAETNA HMO
041668100MedicaidFL
P00145701OtherRAILROAD MEDICARE
7864548OtherAETNA PPO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bhummel6359@Direct.leememorial.org Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME46159FLMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgical Associates of Southwest Florida, M.D., P.a. Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Jul 1, 1966 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bhummel6359@direct.leememorial.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1417999079",
    "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": "239-343-6341",
            "fax_number": "239-343-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 S HEALTHPARK DR STE 156",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083618",
            "telephone_number": "239-343-6341",
            "fax_number": "239-343-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME46159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "53818",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME46159",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3568049",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041668100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00145701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7864548",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhummel6359@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.