Organization Active NPI

Northwestern Medicine Florida Medical Group NFP Corporation

  • General Practice Physician
  • Naples, FL
National Provider Identifier
1508621517
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
NORTHWESTERN MEDICINE FLORIDA MEDICAL GROUP NFP CORPORATION
Practice address
681 4TH Ave N Ste 201
Naples, FL 34102-5729
Phone
(312) 926-2000
NPI assigned
Feb 19, 2024
Organization subpart
Yes
Parent organization
NORTHWESTERN MEMORIAL HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Michael Mullen
Title
VP, Hospital Revenue Cycle, NMHC
Phone
(630) 938-6076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

681 4TH Ave N Ste 201
Naples, FL 34102-5729

Mailing address

Dept 5777
Carol Stream, IL 60122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240701002516 FL Part B Supplier - Clinic/Group Practice 3678017613 Receives reassigned benefits from 4 practitioners
Practice locations: Naples, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2304816Northwestern Medicine Florida Medical Group681 4TH Ave N - Ste 201, Naples, FL 34102Certificate of waiverMay 19, 2028

National Provider Directory

National Provider Directory
Part of
Northwestern Medicine

Locations

681 4th Ave N
Ste 201
Naples, FL 34102
Phone (239) 920-5700

Dept 5777
Carol Stream, IL 60122

Practitioners & affiliated clinicians

Practitioners 4

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": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1508621517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 5777",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "60122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 4TH AVE N STE 201",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025729",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICINE FLORIDA MEDICAL GROUP NFP CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWESTERN MEMORIAL HEALTHCARE",
        "enumeration_date": "2024-02-19",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VP, HOSPITAL REVENUE CYCLE, NMHC",
        "authorized_official_telephone_number": "630-938-6076"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "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 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.