Individual provider Active NPI

Nicholas M Cifelli

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1659473890
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
65249 Issued in FL
Practice address
3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413
Phone
(239) 939-3939
Fax
(239) 931-6116
NPI assigned
Sep 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 65249 FL Primary

Addresses

Primary practice location

3033 Winkler Avenue Ext
Fort Myers, FL 33916-9413

Mailing address

3307 SE 17TH Ave
Cape Coral, FL 33904-4462

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
I20130619000081 FL Order and Referring Only - Family PracticePractitioner - Family Practice 5193964351

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65249FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659473890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 SE 17TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339044462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WINKLER AVENUE EXT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169413",
            "telephone_number": "239-939-3939",
            "fax_number": "239-931-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIFELLI",
        "first_name": "NICHOLAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "65249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.