Individual provider Active NPI

Brandon Alan Madia, D.O.

  • Psychiatry Physician
  • Fort Myers, FL
National Provider Identifier
1487093183
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS12634 Issued in FL
Practice address
12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655
Phone
(239) 343-9180
Fax
(239) 343-9188
NPI assigned
Jun 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS12634 FL Primary

Addresses

Primary practice location

12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180

Other practice location 1

350 7th St N
Naples, FL 34102-5754
Phone (239) 624-1660

Other practice location 2

15901 Bass Rd Ste 108
Fort Myers, FL 33908-3838
Phone (239) 343-6050

Other identifiers 2

IdentifierTypeStateIssuer
022718400MedicaidFL
NR7MTOtherFLBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bmadia252282@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718001520 FL Practitioner - Psychiatry 2860785557 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

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

12550 New Brittany Blvd
Suite 100
Fort Myers, FL 33907-3655
Phone (239) 343-9180

3501 Health Ctr Blvd
Estero, FL 34135-8128

Hospital & facility affiliations

  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS12634FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
David Lawrence Mental Health Center, Inc CurrentSince Jul 1, 2016 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Dec 7, 2020 Accepting new patients
Lee Memorial Health System CurrentSince Dec 7, 2020 Accepting new patients

Locations

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

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

15901 Bass Rd
Ste 108
Fort Myers, FL 33908
Phone (239) 343-9890

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

12550 New Brittany Blvd
Ste 100
Fort Myers, FL 33907
Phone (239) 343-9180

12550 New Brittany Blvd
Fort Myers, FL 33907
Phone (239) 343-9180

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

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

6075 Bathey Ln
Naples, FL 34116
Phone (239) 455-8500

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: bmadia252282@direct.leememorial.org

Organizations & group practices 5

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 1

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": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1487093183",
    "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": "239-343-9180",
            "fax_number": "239-343-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 7th St N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025754",
            "country_code": "US",
            "telephone_number": "239-624-1660",
            "fax_number": "239-624-1661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15901 Bass Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083838",
            "country_code": "US",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-6051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADIA",
        "first_name": "BRANDON",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS12634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022718400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NR7MT",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmadia252282@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.