Individual provider Active NPI

John T Patrick, MD, ANESTESIOLOGIST

  • Anesthesiology Physician
  • Cape Coral, FL
National Provider Identifier
1497790455
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME63832 Issued in FL
Practice address
4120 Del Prado Blvd S
Cape Coral, FL 33904-7165
Phone
(239) 542-2020
Fax
(239) 541-1492
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME63832 FL Primary

Addresses

Primary practice location

4120 Del Prado Blvd S
Cape Coral, FL 33904-7165

Mailing address

3788 Harold Ave
Fort Myers, FL 33901-7744
Phone (239) 931-9894

Other practice location 1

24th Century Medical Center
5416 Town n Country Blvd
Tampa, FL 33615
Phone (813) 549-3800

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
I20051117001023 FL Practitioner - Anesthesiology 4981501004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Coral Eye Center PAGroup PAC ID 5496774515, 18 clinicians

Practice addresses (Care Compare)

4120 Del Prado Blvd S
Cape Coral, FL 33904-7165
Phone (239) 542-2020

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Coral Eye Center, P.a. CurrentSince May 1, 2005 Accepting new patients
Cape Coral Eye Center, P.a. CurrentSince May 1, 2005 Accepting new patients
Spartan Anesthesia Associates PA Anesthesiology CurrentSince Sep 1, 2018 Accepting new patients

Locations

4120 Del Prado Blvd S
Cape Coral, FL 33904
Phone (239) 542-3020

600 N Cattlemen Rd
Ste 100
Sarasota, FL 34232
Phone (941) 234-0498

3333 Cattlemen Rd
Ste 100
Sarasota, FL 34232
Phone (941) 376-4546

2821 Proctor Rd
Sarasota, FL 34231
Phone (941) 870-1872

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1497790455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3788 HAROLD AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017744",
            "telephone_number": "239-931-9894",
            "fax_number": "239-542-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047165",
            "telephone_number": "239-542-2020",
            "fax_number": "239-541-1492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24th Century Medical Center",
            "address_2": "5416 Town n Country Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33615",
            "country_code": "US",
            "telephone_number": "813-549-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD, ANESTESIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME63832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.