Active NPI
Michael Ray Arnold, M.D.
- Pediatric Surgery Physician
- Port Charlotte, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- ME161311
- Practice address
- 22655 Bayshore Rd Ste 110
Port Charlotte, FL 33980-2005 - Phone
- (941) 235-4900
- Fax
- (941) 235-4901
- NPI assigned
- May 9, 2012
- Last updated
- Jun 27, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9105977 | FL | |
| Surgery Physician | 208600000X | 209374 | NC | |
| Pediatric Surgery Physician | 2086S0120X | ME161311 | FL | Primary |
Addresses
Primary practice location
22655 Bayshore Rd Ste 110
Port Charlotte, FL 33980-2005
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-7474
Other practice location 1
16230 Summerlin Rd Ste 215
Fort Myers, FL 33908-5769
Phone (239) 343-7474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118955200 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | marnold334848@Direct.leememorial.org | Direct | Lee Memorial Health System |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1514 Jefferson Hwy
New Orleans, LA 70121
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME161311 | FL | MD | Pediatric Surgery Physician |
| 9105977 | FL | MD | Physician Assistant |
| 209374 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Ochsner Clinic LLC | Surgery | Current | Accepting new patients |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
16230 Summerlin Rd
Ste 215
Fort Myers, FL 33908
Phone (239) 343-7474
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
22655 Bayshore Rd
Ste 110
Punta Gorda, FL 33980
Phone (941) 235-4900
1514 Jefferson Hwy
New Orleans, LA 70121
Interoperability endpoints
- marnold334848@direct.leememorial.org
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
-
dba Lee Health Specialty Pharmacy
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
dba LCH-Golisano Peds PC Bayshore
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
-
dba Diabetes Prevention Program
- Registered Dietitian
- Covington, LA
- NPI 1013747039
-
dba Ochsner St. Anne General Health Ctr-Raceland
- General Practice Physician
- Raceland, LA
- NPI 1508049289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1801155908",
"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": "239-343-7474",
"fax_number": "239-343-4190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22655 BAYSHORE RD STE 110",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802005",
"telephone_number": "941-235-4900",
"fax_number": "941-235-4901"
}
],
"practiceLocations": [
{
"address_1": "16230 Summerlin Rd Ste 215",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339085769",
"country_code": "US",
"telephone_number": "239-343-7474",
"fax_number": "239-343-4190",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ARNOLD",
"first_name": "MICHAEL",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-09",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9105977",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "209374",
"primary": false
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "FL",
"license": "ME161311",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118955200",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "marnold334848@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": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.