Active NPI
Jerome Stephen Mayersak, M.D.
- Urology Physician
- Naples, FL
National Provider Identifier
1720300650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME 14598
- Practice address
- 3480 5TH Ave NW
Naples, FL 34120-1620 - Phone
- (239) 348-2568
- NPI assigned
- Feb 19, 2010
- Last updated
- Feb 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME 14598 | FL | Primary |
Addresses
Primary practice location
3480 5TH Ave NW
Naples, FL 34120-1620
Mailing address
3480 5TH Ave NW
Naples, FL 34120-1620
Phone (239) 348-2568
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 14598 | FL | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266537600000",
"number": "1720300650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3480 5TH AVE NW",
"city": "NAPLES",
"state": "FL",
"postal_code": "341201620",
"telephone_number": "239-348-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3480 5TH AVE NW",
"city": "NAPLES",
"state": "FL",
"postal_code": "341201620",
"telephone_number": "239-348-2568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYERSAK",
"first_name": "JEROME",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-19",
"last_updated": "2010-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME 14598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.