Wally Plante, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME135129 Issued in FL

Practice address

28420 Bonita Xing Blvd Unit 110
Bonita Springs, FL 34135-3203

Phone

(239) 235-0385

Fax

(239) 343-7008

NPI assigned

May 19, 2014

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

PsychiatryAlso: Neurology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pure Healthcare of Florida LLCGroup PAC ID 8729496500, 5 clinicians

Florida Memory Care and Neurology Services LLCGroup PAC ID 1951719459, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Naples Community Hospital Hospital, Naples, FL, CCN 100018
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: memorytreatmentcenter.wallyplante@149496.advancedmd-direct.com
• Direct secure messaging: wally.plante.1@8967.direct.athenahealth.com

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.

• Florida Memory Care and Neurology Services LLC

  • Multi-Specialty Clinic/Center
  • Bonita Springs, FL
  • NPI 1700479094
  Medicare reassignment Care Compare group NPD
• Pure Healthcare of Florida LLC

  • Multi-Specialty Clinic/Center
  • Bonita Springs, FL
  • NPI 1093308397
  Medicare reassignment Care Compare group NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• Pure Infusion of Florida LLC

  • Multi-Specialty Clinic/Center
  • Bonita Springs, FL
  • NPI 1164304523
  NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  dba Cape Coral Hospital

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation
• Naples Community Hospital Inc

  dba NCH Healthcare System Inc

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1720085137
  Care Compare affiliation

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1558772061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28420 BONITA CROSSINGS BLVD UNIT 110",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341353203",
            "telephone_number": "239-235-0385",
            "fax_number": "239-237-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28420 BONITA XING BLVD UNIT 110",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341353203",
            "telephone_number": "239-235-0385",
            "fax_number": "239-343-7008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 The Greens Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322501422",
            "country_code": "US",
            "telephone_number": "904-800-7380",
            "fax_number": "904-467-8932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8360 Sierra Meadows Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341137328",
            "country_code": "US",
            "telephone_number": "239-744-2175",
            "fax_number": "239-307-2681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLANTE",
        "first_name": "WALLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME135129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100164900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pilot Healthcare P.L.
• Robert Richard Pinello, PAC MPAS
• Roger Jacob Pint Jr., D.M.D. M.P.H.
• Michael Ryan Pinter, SSP
• Sandi Lynn Pisano
• Play to Heal Collective, Inc.
• Morgan Plocharczyk, DPT
• Virgil Anthony Ponzoli Jr., MD
• Juliette Porto, APRN
• Stephen Poulos, M.D.

• Neurology Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.