Individual provider Active NPI

Erin E Mallari, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1689683047
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103462 Issued in FL
Practice address
8791 Conference Dr Ste 100
Fort Myers, FL 33919-5822
Phone
(239) 331-5566
Fax
(239) 437-7499
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103462 FL Primary

Addresses

Primary practice location

8791 Conference Dr Ste 100
Fort Myers, FL 33919-5822

Mailing address

8791 Conference Dr Ste 100
Fort Myers, FL 33919-5822
Phone (239) 331-5566

Other practice location 1

2780 Cleveland Ave
Suite 702
Fort Myers, FL 33901-5858
Phone (239) 343-3474

Other practice location 2

2 Tampa General Cir
Tampa, FL 33606-3603
Phone (813) 974-2201

Other identifiers 3

IdentifierTypeStateIssuer
292574500MedicaidFL
LG171OtherFLMEDICARE
Y01T5OtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Erin E Ross Former name

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
I20060328000563 FL Practitioner - Physician Assistant 7911915293 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Radiology Consultants P aGroup PAC ID 3678471943, 70 clinicians

Practice addresses (Care Compare)

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 331-5566

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 938-3571

8192 College Pkwy
Suite 6
Fort Myers, FL 33919-5175
Phone (239) 481-8022

9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-6650

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Tampa General Hospital Current Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients

Locations

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

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

6311 S Pointe Blvd
Ste 600
Fort Myers, FL 33919
Phone (239) 343-9150

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

2780 Cleveland Ave
Ste 702
Fort Myers, FL 33901
Phone (239) 332-6474

9981 S Healthpark Dr
Ste 120
Fort Myers, FL 33908
Phone (239) 343-6341

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

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

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

Interoperability endpoints

  • Direct secure messaging: emallari155153@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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 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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1689683047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8791 CONFERENCE DR STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195822",
            "telephone_number": "239-331-5566",
            "fax_number": "239-437-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8791 CONFERENCE DR STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195822",
            "telephone_number": "239-331-5566",
            "fax_number": "239-437-7499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Cleveland Ave",
            "address_2": "Suite 702",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015858",
            "country_code": "US",
            "telephone_number": "239-343-3474",
            "fax_number": "239-343-2968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063603",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLARI",
        "first_name": "ERIN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292574500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LG171",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y01T5",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "ROSS",
            "middle_name": "E",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.