Individual provider Active NPI

Patrick G Mora, PA-C

  • Surgical Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1437112638
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9100684 Issued in FL
Practice address
9981 S Healthpark Dr
Suite 120
Fort Myers, FL 33908-3618
Phone
(239) 343-6341
Fax
(239) 343-6342
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9100684 FL Primary

Addresses

Primary practice location

9981 S Healthpark Dr
Suite 120
Fort Myers, FL 33908-3618

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
290465900MedicaidFL
192485OtherFLAMERIGROUP
2904659-00MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmora2233@Direct.leememorial.org Lee Memorial Health System

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040429000245 FL Practitioner - Physician Assistant 4789671991 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

311 9TH St N
Naples, FL 34102-5886

350 7TH St N
Naples, FL 34102-5754

680 2ND Ave N
Suite 304
Naples, FL 34102-5757
Phone (239) 261-7711

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Jan 20, 2025 Accepting new patients
Nchmd Inc CurrentSince Aug 3, 2017 Accepting new patients
Lee Memorial Health System CurrentSince Jun 29, 2015 Accepting new patients
Nchmd, Inc CurrentSince Aug 3, 2017 Accepting new patients
Lee Health System Inc CurrentSince Jan 20, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Jun 29, 2015 Accepting new patients
Cape Coral Emergency Physicians Past Accepting new patients
Mora Professional Services Inc PastSince Feb 21, 2012 Accepting new patients
Gulf Coast Cardiothoracic Surgeons Past Accepting new patients
All X Ray Diagnostic Services Corp Surgical Past Accepting new patients
Cardiac Surgical Associates of Southwest Florida, M.D., P.a. Past Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

632 Del Prado Blvd N
Ste 101
Cape Coral, FL 33909
Phone (239) 772-5577

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

9981 S Healthpark Dr
Ste 156
Fort Myers, FL 33908
Phone (239) 343-5333

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

12700 Creekside Ln
Ste 101
Fort Myers, FL 33919
Phone (239) 432-0774

9981 S Healthpark Dr
Ste 120
Fort Myers, FL 33908
Phone (239) 343-6341

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

399 Tamiami Trl N
Ste 300
Naples, FL 34102
Phone (239) 624-4200

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: pmora2233@direct.leememorial.org

Organizations & group practices 12

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1437112638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MEYERS",
            "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",
            "address_2": "SUITE 120",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083618",
            "telephone_number": "239-343-6341",
            "fax_number": "239-343-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "PATRICK",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9100684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290465900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "192485",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2904659-00",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmora2233@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

Verify at the official NPI Registry.