Individual provider Active NPI

Kish L Hill, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1700221751
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117324 Issued in FL
Practice address
8960 Colonial Center Dr Ste 202
Fort Myers, FL 33905-7810
Phone
(239) 343-9646
Fax
(239) 343-9681
NPI assigned
May 3, 2013
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X 12-0839 CA
Physician Assistant 363A00000X 55141 CA
Physician Assistant 363A00000X PA9117324 FL Primary

Addresses

Primary practice location

8960 Colonial Center Dr Ste 202
Fort Myers, FL 33905-7810

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9646

Other identifiers 1

IdentifierTypeStateIssuer
119551400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khill346122@Direct.leememorial.org Direct Lee Memorial Health System

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191107000723 CA Practitioner - Physician Assistant 8729348354 Reassigns benefits to 1 organization
I20230927001429 FL Practitioner - Physician Assistant 8729348354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

3501 Health Ctr Blvd
Suite 2410
Estero, FL 34135-8131
Phone (239) 468-0285

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55141CAMDOncology Pharmacist
12-0839CAMDOther Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 3, 2019 Accepting new patients
Lee Memorial Health System CurrentSince Oct 2, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Physician Assistant CurrentSince Sep 3, 2019 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 2, 2023 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Grossmont Medical Clinic a Professional Corporation Past Accepting new patients
Jabari Reeves MD Medical Corporation Past Accepting new patients

Locations

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

2929 Health Center Dr
San Diego, CA 92123
Phone (858) 939-6531

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

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

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

8960 Colonial Center Dr
Ste 202
Fort Myers, FL 33905
Phone (239) 343-9646

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

Interoperability endpoints

  • Direct secure messaging: khill346122@direct.leememorial.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1700221751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9646",
            "fax_number": "239-343-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8960 COLONIAL CENTER DR STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057810",
            "telephone_number": "239-343-9646",
            "fax_number": "239-343-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "KISH",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "CA",
            "license": "12-0839",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55141",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119551400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khill346122@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.