Individual provider Active NPI

Michael Ray Arnold, M.D.

  • Pediatric Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1801155908
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
ME161311 Issued in FL
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
118955200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
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, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230814000030 FL Practitioner - General Surgery 3870990765 Reassigns benefits to 2 organizations
I20251110003985 LA Practitioner - Pediatric Medicine 3870990765 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
ME161311FLMDPediatric Surgery Physician
9105977FLMDPhysician Assistant
209374NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Oct 22, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Aug 14, 2023 Accepting new patients
Ochsner Clinic LLC CurrentSince Oct 22, 2025 Accepting new patients
Ochsner Clinic LLC Surgery Current Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Aug 14, 2023 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.