Individual provider Active NPI

Annicol Marrocco, MD

  • Emergency Medicine Physician
  • Ft Myers, FL
National Provider Identifier
1699747642
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0091152 Issued in FL
Practice address
13681 Doctors Way
Ft Myers, FL 33912-4300
Phone
(239) 768-8611
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0091152 FL Primary

Addresses

Primary practice location

13681 Doctors Way
Ft Myers, FL 33912-4300

Mailing address

285 Grande Way Apt 503
Naples, FL 34110-6487
Phone (239) 596-2481

Other identifiers 2

IdentifierTypeStateIssuer
52203OtherFLBCBS
271992400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041210000784 FL Practitioner - Emergency Medicine 2163417288 Reassigns benefits to 1 organization
I20110923000250 TX Practitioner - Emergency Medicine 2163417288 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0091152FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Aug 1, 2012 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Aug 3, 2011 Accepting new patients
Lisa Cicetti PSYD LMHC Inc. CurrentSince Dec 1, 2019 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Aug 1, 2012 Accepting new patients
Emergency Physicians of Saint Clares LLC Emergency Medicine PastSince Jan 1, 2012 Accepting new patients
Collier Emergency Specialists LLC Emergency Medicine Past Accepting new patients
South Gulf Coast Emergency Physicians PA Emergency Medicine Past Accepting new patients
Pride Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Hogarth Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

2500 Quantum Lakes Dr
Ste 203
Boynton Beach, FL 33426
Phone (561) 502-1992

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1699747642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 GRANDE WAY APT 503",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341106487",
            "telephone_number": "239-596-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13681 DOCTORS WAY",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339124300",
            "telephone_number": "239-768-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARROCCO",
        "first_name": "ANNICOL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0091152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52203",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271992400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Myers, FL

Sources for this page

Verify at the official NPI Registry.