Individual provider Active NPI

Brandon Scot Patri, DO

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1568025344
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS18753 Issued in FL
Practice address
16271 Bass Rd
Fort Myers, FL 33908-3616
Phone
(239) 343-7100
Fax
(239) 343-7190
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS18753 FL Primary

Addresses

Primary practice location

16271 Bass Rd
Fort Myers, FL 33908-3616

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-7100

Other practice location 1

350 7th St N
Naples, FL 34102-5754
Phone (239) 624-0940

Other identifiers 1

IdentifierTypeStateIssuer
114896400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpatri301041@Direct.leememorial.org Direct Lee Memorial Health System

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
I20220721001781 FL Practitioner - Internal Medicine 9931434503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

16271 Bass Rd
Fort Myers, FL 33908-3616
Phone (239) 432-3322

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS18753FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Internal Medicine CurrentSince Sep 11, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Sep 11, 2022 Accepting new patients

Locations

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

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

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

16271 Bass Rd
Fort Myers, FL 33908
Phone (239) 343-7100

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

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

Interoperability endpoints

  • Direct secure messaging: bpatri301041@direct.leememorial.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1568025344",
    "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": "239-343-7100",
            "fax_number": "239-343-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16271 BASS RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083616",
            "telephone_number": "239-343-7100",
            "fax_number": "239-343-7190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 7th St N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025754",
            "country_code": "US",
            "telephone_number": "239-624-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRI",
        "first_name": "BRANDON",
        "middle_name": "SCOT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS18753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114896400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpatri301041@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.