Individual provider Active NPI

Thomas E Kowalsky, MD

  • Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1457316036
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0048210 Issued in FL
Practice address
21 Barkley Circle
Fort Myers, FL 33907
Phone
(239) 939-2616
Fax
(239) 939-9093
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME0048210 FL Primary
Vascular Surgery Physician 2086S0129X ME0048210 FL

Addresses

Primary practice location

21 Barkley Circle
Fort Myers, FL 33907

Mailing address

2234 Colonial Blvd
Managed Care Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 7

IdentifierTypeStateIssuer
974397OtherFLWELLCARE
206369OtherAVMED
044255100MedicaidFL
4109759OtherFLAETNA PROVIDER #
1114981OtherFLCIGNA PROVIDER #
205689OtherAMERIGROUP
36427OtherFLBCBS PROVIDER #

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070806000672 FL Practitioner - General SurgeryPractitioner - Vascular Surgery 5496752370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Temple University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

21 Barkley Cir
Fort Myers, FL 33907-7531
Phone (239) 939-2616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)12
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0048210FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC CurrentSince Feb 1, 2007 Accepting new patients
Genesiscare USA of Florida LLC Surgery Current Accepting new patients
Genesiscare USA of Florida LLC Surgery CurrentSince Feb 1, 2007 Accepting new patients

Locations

1206 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 226-2727

3680 Broadway
Fort Myers, FL 33901
Phone (239) 936-0380

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

21 Barkley Cir
Fort Myers, FL 33907
Phone (239) 939-2616

8925 Colonial Center Dr
Ste 1001
Fort Myers, FL 33905
Phone (239) 343-5864

2160 Colonial Blvd
Fort Myers, FL 33907

431 University Blvd
Jupiter, FL 33458
Phone (561) 296-9147

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: thomas.kowalsky@agvs.directbygreenway.com

Organizations & group practices 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1457316036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "MANAGED CARE DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BARKLEY CIRCLE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-939-2616",
            "fax_number": "239-939-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKY",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0048210",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME0048210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "974397",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "206369",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044255100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "4109759",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "1114981",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "205689",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "36427",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.