Organization Active NPI

Associates in Digestive Health LLC

  • Gastroenterology Physician
  • Cape Coral, FL
National Provider Identifier
1790868099
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ASSOCIATES IN DIGESTIVE HEALTH LLC
Practice address
625 Del Prado Blvd S
Cape Coral, FL 33990-2667
Phone
(239) 772-3636
Fax
(239) 772-5073
NPI assigned
Oct 23, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kris Breyley, RN
Title
Practice Administrator
Phone
(239) 772-3636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X FL Primary

Addresses

Primary practice location

625 Del Prado Blvd S
Cape Coral, FL 33990-2667

Mailing address

625 Del Prado Blvd S
Cape Coral, FL 33990-2667
Phone (239) 772-3636

Other identifiers 3

IdentifierTypeStateIssuer
7519547OtherFLAETNA
269648700MedicaidFL
45406OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329001722 FL Part B Supplier - Clinic/Group Practice 8628960937 Receives reassigned benefits from 92 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cape Coral, FL; Tampa, FL; Orange City, FL; Naples, FL; Lake Mary, FL; Fort Myers, FL; Deland, FL; Bonita Springs, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

101 Riverfront Blvd
Ste 700
Bradenton, FL 34205
Phone (941) 748-2417

2721 Del Prado Blvd S
Ste 200
Cape Coral, FL 33904
Phone (239) 458-6677

625 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 574-3323

625 Del Prado Blvd S
Ste 200
Cape Coral, FL 33990
Phone (239) 772-3636

665 Del Prado Blvd S
Ste 1
Cape Coral, FL 33990
Phone (239) 772-3636

929 N Spring Garden Ave
Ste 150
Deland, FL 32720
Phone (386) 339-2692

900 Pine St
Ste 212
Englewood, FL 34223

13051 University Dr
Ste 101
Fort Myers, FL 33907
Phone (239) 433-3636

1620 Medical Ln
#150C
Fort Myers, FL 33907
Phone (239) 939-4604

417A Racetrack Rd NW
Ste 2
Ft Walton Bch, FL 32547
Phone (850) 863-5990

1217 S East Ave
Ste 210
Sarasota, FL 34239
Phone (941) 366-4015

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790868099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902667",
            "telephone_number": "239-772-3636",
            "fax_number": "239-772-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902667",
            "telephone_number": "239-772-3636",
            "fax_number": "239-772-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN DIGESTIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BREYLEY",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "239-772-3636",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7519547",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269648700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45406",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.