Mitchell Scott Fadley, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS21168 Issued in FL

Practice address

42880 Crescent Loop Ste 110
Punta Gorda, FL 33982-5062

Phone

(239) 343-3535

Fax

(239) 343-4065

NPI assigned

May 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aveanna Home Health Home health agency, Sarasota, FL, CCN 108480
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfadley406009@direct.leememorial.org

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.

• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319

  Family Medicine

  Medicare reassignment NPD
• Lee Health System Inc

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Doctor'S Choice Home Care, LLC

  • Home Health Agency
  • Sarasota, FL
  • NPI 1205051497
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1760056980",
    "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": "239-343-3535",
            "fax_number": "239-343-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42880 CRESCENT LOOP STE 110",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339825062",
            "telephone_number": "239-343-3535",
            "fax_number": "239-343-4065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 Union St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013054",
            "country_code": "US",
            "telephone_number": "207-973-7973",
            "fax_number": "207-947-9579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FADLEY",
        "first_name": "MITCHELL",
        "middle_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS21168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123005000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfadley406009@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": []
}

• Shannyn O'Keefe Estevez, APRN
• Christina Eubanks, HAS
• Eyecare and Surgery Center of
• Eyecare and Surgery Center of Southwest Florida, LLC
• Fabiola Anglade-Pascal, PLLC
• Pamela Kay Fadness, M.D.
• Abigail Hobbs Faerber, D.O.
• Leanne Fahey, LMFT
• Family Home Medical Equipment & Supplies, LLC
• Daniel Edward Farris, R.PH.

• Family Medicine Physician in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.