Individual provider Active NPI

Alicia Bisplinghoff

  • Physician Assistant
  • Port Charlotte, FL
National Provider Identifier
1811758642
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118351 Issued in FL
Practice address
4130 Tamiami TRL # 2
Port Charlotte, FL 33952-9207
Phone
(941) 787-7111
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9118351 FL Primary

Addresses

Primary practice location

4130 Tamiami TRL # 2
Port Charlotte, FL 33952-9207

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206001085 FL Practitioner - Physician Assistant 9931542024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Florida State University College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

13807 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 257-1108

13815 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 426-4900

13823 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 888-0770

150 W McKenzie St
Punta Gorda, FL 33950-5500
Phone (941) 621-6476

171 Ctr Rd
Venice, FL 34285-5572
Phone (941) 499-5407

177 Ctr Rd
Venice, FL 34285-5572
Phone (941) 207-5350

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2315 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 613-2222

2335 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 787-7665

2343 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 629-2900

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

4130 Tamiami TRL
Suite 2
Port Charlotte, FL 33952-9207
Phone (941) 787-7100

900 Pine St
Suite 221
Englewood, FL 34223-4458
Phone (941) 548-1708

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9118351FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Feb 19, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Feb 19, 2024 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: alicia.bisplinghoff.1@4290.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1811758642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 TAMIAMI TRL # 2",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529207",
            "telephone_number": "941-787-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISPLINGHOFF",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.