Linda Marian Yarris-Ewert, PH.D, M.D., P.A.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0064852 Issued in FL

Practice address

12545 New Brittany Blvd
Suite 26
Fort Myers, FL 33907-3625

Phone

(239) 274-2071

Fax

(239) 274-2075

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880

  Family Medicine, FL

  Medicare reassignment NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702

  Family Medicine

  NPD
• Fort Myers Gynecology, LLC

  • Gynecology Physician
  • Fort Myers, FL
  • NPI 1477273076
  NPD (past)
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1780796359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12545 NEW BRITTANY BLVD",
            "address_2": "SUITE 26",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073625",
            "telephone_number": "239-274-2071",
            "fax_number": "239-274-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 NEW BRITTANY BLVD",
            "address_2": "SUITE 26",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073625",
            "telephone_number": "239-274-2071",
            "fax_number": "239-274-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARRIS-EWERT",
        "first_name": "LINDA",
        "middle_name": "MARIAN",
        "name_prefix": "Mrs.",
        "credential": "PH.D, M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0064852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA INSURANCE",
            "identifier": "AS19990440001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL HEALTHY KIDS",
            "identifier": "194736",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "23801",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTHCARE",
            "identifier": "2666792",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374409400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary C Yankaskas, M.D.
• Konstantine Konstantine Yankopolus, MD
• Heidi L Yankovich, P.T.
• Lara Yarick, RPH
• Ravi Yarlagadda, MD
• Fady Samah Samy Yassa
• Usama Yassi, M.D.
• Noor Yassine, DO
• Shannon Yates
• John Dennis Yavorsky, D.D.S., M.S.

• All providers in Fort Myers, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.

Verify at the official NPI Registry.