Individual provider Active NPI

Alexander W. Hodulik, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1609493964
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113326 Issued in FL
Practice address
6821 Palisades Park CT Ste 1
Fort Myers, FL 33912-7131
Phone
(239) 936-8555
NPI assigned
Jul 2, 2020
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113326 FL Primary
Vascular Surgery Physician 2086S0129X PA9113326 FL

Addresses

Primary practice location

6821 Palisades Park CT Ste 1
Fort Myers, FL 33912-7131

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-3780

Other practice location 1

6201 Alliance Ln Ste 200
Fort Myers, FL 33912-7165
Phone (239) 343-3780

Other identifiers 1

IdentifierTypeStateIssuer
110101100MedicaidFL

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
I20210422000077 FL Practitioner - Physician Assistant 1456769934 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
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

12700 Creekside LN
Fort Myers, FL 33919-3356

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

708 Del Prado Blvd S
Cape Coral, FL 33990-2676

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113326FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Jun 2, 2025 Accepting new patients
Lee Health System Inc CurrentSince Jun 2, 2025 Accepting new patients

Locations

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

6201 Alliance Ln
Ste 200
Fort Myers, FL 33912
Phone (239) 343-1176

Interoperability endpoints

  • Direct secure messaging: ahodulik261704@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1609493964",
    "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": "239-343-3780",
            "fax_number": "239-343-3781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6821 PALISADES PARK CT STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339127131",
            "telephone_number": "239-936-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 Alliance Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339127165",
            "country_code": "US",
            "telephone_number": "239-343-3780",
            "fax_number": "239-343-3781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODULIK",
        "first_name": "ALEXANDER",
        "middle_name": "W.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-02",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113326",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "PA9113326",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110101100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.