Individual provider Active NPI

Samaris Berenice Corona, MD

  • Obstetrics & Gynecology Physician
  • Fort Myers, FL
National Provider Identifier
1619401296
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
151418 Issued in FL
Practice address
9021 Park Royal Dr
Fort Myers, FL 33908-9617
Phone
(239) 432-5858
Fax
(239) 482-6297
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 151418 FL Primary

Addresses

Primary practice location

9021 Park Royal Dr
Fort Myers, FL 33908-9617

Mailing address

9021 Park Royal Dr
Fort Myers, FL 33908-9617
Phone (239) 432-5858

Other practice location 1

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-2563

Other practice location 2

1265 Viscaya Pkwy
Cape Coral, FL 33990-3237
Phone (239) 574-2229

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
I20210802000158 FL Practitioner - Obstetrics/Gynecology 7214203322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

9021 Park Royal Dr
Fort Myers, FL 33908-9617
Phone (239) 481-5437

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151418FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC Obstetrics & Gynecology CurrentSince Aug 16, 2021 Accepting new patients
Womencare PA Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

1265 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 573-7337

1606 Santa Barbara Blvd
Cape Coral, FL 33991
Phone (239) 574-2229

9021 Park Royal Dr
Fort Myers, FL 33908
Phone (239) 432-5858

3230 Forum Blvd
Fort Myers, FL 33905
Phone (239) 432-5858

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: samaris.corona.1@2183.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1619401296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9021 PARK ROYAL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089617",
            "telephone_number": "239-432-5858",
            "fax_number": "239-482-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 PARK ROYAL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089617",
            "telephone_number": "239-432-5858",
            "fax_number": "239-482-6297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Dixmyth Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452202475",
            "country_code": "US",
            "telephone_number": "513-862-2563",
            "fax_number": "513-862-4980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1265 Viscaya Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339903237",
            "country_code": "US",
            "telephone_number": "239-574-2229",
            "fax_number": "239-574-2762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORONA",
        "first_name": "SAMARIS",
        "middle_name": "BERENICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "151418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.