Individual provider Active NPI

Walter G Sorokoty II

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
National Provider Identifier
1528089869
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN3215792 Issued in FL
Practice address
12511 World Plaza LN
BLDG 50
Fort Myers, FL 33907-3991
Phone
(239) 939-2622
Fax
(239) 939-0151
NPI assigned
Jul 22, 2006
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN3215792 FL Primary
Certified Registered Nurse Anesthetist 367500000X ANT3215792 FL

Addresses

Primary practice location

12511 World Plaza LN
BLDG 50
Fort Myers, FL 33907-3991

Mailing address

1417 Claret CT
Fort Myers, FL 33919-3407
Phone (904) 614-1405

Other identifiers 1

IdentifierTypeStateIssuer
G4053OtherFLBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070103000004 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113927898 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology Services of Florida IncGroup PAC ID 1850674540, 159 clinicians

Practice addresses (Care Compare)

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 493-5005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ANT3215792FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Services of Florida, Inc. CurrentSince Mar 1, 2024 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 10, 2020 Accepting new patients
Anesthesia & Pain Consultants of SW FL CurrentSince Jul 5, 2006 Accepting new patients
Jacksonville Anesthesia Corporation Inc Past Accepting new patients
North Florida Anesthesia Consultants, Inc. Past Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients

Locations

12511 World Plaza Ln
Bldg 50
Fort Myers, FL 33907
Phone (239) 939-4903

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

4035 Evans Ave
Fort Myers, FL 33901
Phone (941) 939-4937

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1528089869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 CLARET CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193407",
            "telephone_number": "904-614-1405",
            "fax_number": "239-939-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 WORLD PLAZA LN",
            "address_2": "BLDG 50",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073991",
            "telephone_number": "239-939-2622",
            "fax_number": "239-939-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOROKOTY",
        "first_name": "WALTER",
        "middle_name": "G",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN3215792",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ANT3215792",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G4053",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.