Organization Active NPI

Frederick Adolf Paola MD JD LLC

  • Internal Medicine Physician
  • Naples, FL
National Provider Identifier
1437852373
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FREDERICK ADOLF PAOLA MD JD LLC
Practice address
6400 Davis Blvd Ste 104
Naples, FL 34104-5321
Phone
(239) 624-0650
NPI assigned
Mar 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Elizabeth Ross
Title
Credentialing Manager
Phone
(239) 732-1133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6400 Davis Blvd Ste 104
Naples, FL 34104-5321

Mailing address

9636 Montelanico Loop Unit 204
Naples, FL 34119-2146
Phone (239) 595-4976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230711002401 FL Part B Supplier - Clinic/Group Practice 7416316245 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

5077 Tamiami Trl E
Naples, FL 34113
Phone (239) 732-1133

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1437852373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9636 MONTELANICO LOOP UNIT 204",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341192146",
            "telephone_number": "239-595-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 DAVIS BLVD STE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341045321",
            "telephone_number": "239-624-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK ADOLF PAOLA MD JD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "239-732-1133"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.