Individual provider Active NPI

Thomas Schiller, M.D.

  • Pediatrics Physician
  • Fort Myers, FL
National Provider Identifier
1770570954
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0051333 Issued in FL
Practice address
4751 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone
(239) 343-9888
Fax
(239) 343-9868
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0051333 FL Primary

Addresses

Primary practice location

4751 S Cleveland Ave
Fort Myers, FL 33907-1317

Mailing address

PO Box 2147
Ft Myers, FL 33902-2147
Phone (239) 343-9888

Other practice location 1

650 Del Prado Blvd S Ste 107
Cape Coral, FL 33990-5629
Phone (239) 343-9888

Other identifiers 1

IdentifierTypeStateIssuer
046530500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tschiller380@Direct.leememorial.org 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050311000822 FL Practitioner - Pediatric Medicine 3779537758 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0051333FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Primary Care of Southwest Florida PL Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tschiller380@direct.leememorial.org

Organizations & group practices 2

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1770570954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9888",
            "fax_number": "239-424-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 S CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071317",
            "telephone_number": "239-343-9888",
            "fax_number": "239-343-9868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Del Prado Blvd S Ste 107",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339905629",
            "country_code": "US",
            "telephone_number": "239-343-9888",
            "fax_number": "239-424-4091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHILLER",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0051333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046530500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tschiller380@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "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.