George E Kopidakis, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME74612 Issued in FL

Practice address

1530 Lee Blvd
Suite 1100
Lehigh Acres, FL 33936-4893

Phone

(239) 368-0241

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• George E Kopidakis MD Facs PC

  • Surgery Physician
  • Edison, NJ
  • NPI 1407920853
  NPD (past) Authorized official
• Prime Healthcare Services - Lehigh Physician Management LLC

  • Surgery Physician
  • Lehigh Acres, FL
  • NPI 1114385655
  NPD
• Springfield Hospital Inc

  dba Springfield Specialty Physicians

  • Anesthesiology Physician
  • Springfield, VT
  • NPI 1780657783

  Surgery

  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1679556757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 LEE BLVD",
            "address_2": "SUITE 1100",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364893",
            "telephone_number": "239-368-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LEE BLVD",
            "address_2": "SUITE 1100",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364893",
            "telephone_number": "239-368-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPIDAKIS",
        "first_name": "GEORGE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME74612",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "MA05921000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P951167",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009552700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "367678",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01214443",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P1011919",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "802555",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0900046",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "14R8X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gordon J Kleinpell, DPM
• Leeann Christine Knapp, MS CCC/SLP
• Shawna Lynn Knowles, MA/PHLEBOTOMIST CPT
• Andrew Peter Kontos, M.D.
• Alexandra May Koontz
• Makaela Manner Kunstler, D.M.D.
• Emily Ann Kupper, PT, DPT
• Lidia Kurquis
• Ana Laura La Rosa Mosquera
• Silvia Elena La Rosa Orjales

• Surgery Physician in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.