Patrick Shin Maeng, M.D.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

110726 Issued in FL

Practice address

12748 University Dr
Fort Myers, FL 33907-5634

Phone

(239) 437-5500

Fax

(239) 437-5507

NPI assigned

Jun 19, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patrickmaeng@csppfl.allscriptsdirect.net

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.

• Children'S Specialist Pediatric Pulmonology of Florida LLC

  • Specialist
  • Fort Myers, FL
  • NPI 1497944193
  NPD

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1790946069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12748 UNIVERSITY DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075634",
            "telephone_number": "239-437-5500",
            "fax_number": "239-437-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12748 UNIVERSITY DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075634",
            "telephone_number": "239-437-5500",
            "fax_number": "239-437-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAENG",
        "first_name": "PATRICK",
        "middle_name": "SHIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME110726",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "110726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003949600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrickmaeng@csppfl.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "12748 University Dr",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339075634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kayla Maczuga, PA-C
• Firas Madbak, M.D.
• Brandon Alan Madia, D.O.
• Olga Madrid, MA
• Najette Maduri, MT-BC
• Louis Thomas Magas, M.D.
• Magdan LLC
• Magdan LLC
• Magdan LLC
• Tiffani Dionne Magee, M.D.

• Pediatric Pulmonology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatric Pulmonology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.