Active NPI
Nicholas Antoon, M.D.
- Emergency Medicine Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME139547
- Practice address
- 2776 Cleveland Ave
Fort Myers, FL 33901-5864 - Phone
- (239) 343-3292
- Fax
- (239) 343-3695
- NPI assigned
- Jul 6, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME139547 | FL | Primary |
Addresses
Primary practice location
2776 Cleveland Ave
Fort Myers, FL 33901-5864
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-3292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103330600 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nantoon280510@Direct.leememorial.org | Direct | Lee Memorial Health System |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME139547 | FL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Emergency Physicians of Central Florida LLP | Emergency Medicine | Current | 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
1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761
1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700
13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000
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
9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200
1414 S Orange Ave
Orlando, FL 32806
Phone (407) 240-4520
1414 S Orange Ave
#112
Orlando, FL 32806
Phone (407) 767-1200
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- nantoon280510@direct.leememorial.org
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Orlando, FL
- NPI 1326033341
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641945600000",
"number": "1740632520",
"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": "239-343-3292",
"fax_number": "239-343-3695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2776 CLEVELAND AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339015864",
"telephone_number": "239-343-3292",
"fax_number": "239-343-3695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOON",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-06",
"last_updated": "2022-01-12",
"certification_date": "2022-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME139547",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103330600",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nantoon280510@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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.