Individual provider Active NPI

Maria Elisa Marconi, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1508395633
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3253 Issued in TN
Practice address
4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone
(239) 343-9800
Fax
(239) 343-9848
NPI assigned
Jun 12, 2017
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3253 TN Primary

Addresses

Primary practice location

4771 S Cleveland Ave
Fort Myers, FL 33907-1317

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9800

Other identifiers 1

IdentifierTypeStateIssuer
104911500MedicaidFL

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
I20190222002522 FL Practitioner - Physician Assistant 6901145788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

1682 NE Pine Island Rd
Cape Coral, FL 33909-1756
Phone (239) 424-1600

3501 Health Ctr Blvd
Estero, FL 34135-8127

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3253TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Oct 9, 2020 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Jan 20, 2020 Accepting new patients

Locations

7593 Boynton Beach Blvd
Ste 190
Boynton Beach, FL 33437
Phone (561) 572-3200

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

1682 NE Pine Island Rd
Cape Coral, FL 33909
Phone (239) 424-1600

507 Cape Coral Pkwy E
Cape Coral, FL 33904
Phone (239) 541-4420

13340 Metro Pkwy
Ste 100
Fort Myers, FL 33966
Phone (239) 343-0490

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

16230 Summerlin Rd
Ste 213
Fort Myers, FL 33908
Phone (239) 343-7450

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

4771 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9800

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

8849 State Road 52
Hudson, FL 34667
Phone (727) 863-7150

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

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1120 Homestead Rd N
Lehigh Acres, FL 33936
Phone (239) 303-5020

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mmarconi223706@direct.leememorial.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1508395633",
    "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": "239-343-9800",
            "fax_number": "239-343-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 S CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071317",
            "telephone_number": "239-343-9800",
            "fax_number": "239-343-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCONI",
        "first_name": "MARIA",
        "middle_name": "ELISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104911500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.