Fernando A Carballo, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME137751 Issued in FL

Practice address

8380 Riverwalk Park Blvd Ste 310
Fort Myers, FL 33919-8758

Phone

(239) 291-3602

Fax

(239) 291-3603

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fernando.carballo.2@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1427010362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 RIVERWALK PARK BLVD STE 310",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198758",
            "telephone_number": "239-291-3602",
            "fax_number": "239-291-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBALLO",
        "first_name": "FERNANDO",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "53132",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME137751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00742968",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32471200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine L Capps, RD
• Nicholas Frank Caputo, D.C
• Cristina Caracheo
• Joseph William Caravella, DO
• Adria Carballo
• Marcia Carbo Calas, MD
• Jennifer Carbone, M.D.
• Mary Terese Carbone, M.D.
• Gabrielle Cardamone
• Ivette Cardelle, B.S.

• Gastroenterology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.

Verify at the official NPI Registry.