Michael Christopher Ianniello, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS15474 Issued in FL

Practice address

27160 Bay Landing Dr Ste 201
Bonita Springs, FL 34135-4301

Phone

(239) 366-5062

Fax

(239) 366-5063

NPI assigned

May 7, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.ianniello.1@4692.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/CJGBDA

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.

• Comprehensive Hospitalists of Florida, LLC

  • Hospitalist Physician
  • Lake Wales, FL
  • NPI 1457646903
  Medicare reassignment NPD
• Mel-Bay Health Care Inc

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1407162654
  Medicare reassignment NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880

  Internal Medicine

  Medicare reassignment NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD

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

{
    "created_epoch": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1821444951",
    "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": "27160 BAY LANDING DR STE 201",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354301",
            "telephone_number": "239-366-5062",
            "fax_number": "239-366-5063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24231 Walden Center Dr",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "341345013",
            "country_code": "US",
            "telephone_number": "239-348-4325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANNIELLO",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-07",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.ianniello.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR address",
            "address_1": "24231 Walden Center Dr",
            "city": "Estero",
            "state": "FL",
            "country_code": "US",
            "postal_code": "341345013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremy Daniel Howard, ATC, CES, PES
• Hsre-Ahr Bonita Springs TRS LLC
• Wendy G Huelsman, MSPT
• Bryan T Hunte, D.C.
• Alyssa Hussey
• Imac Management of Florida, LLC
• Imed Diagnostic Services of Bonita Springs LLC
• Inmotion Health and Fitness, Inc.
• Inmotion Physical Therapy, LLC
• Innovative Pharmacy Solutions LLC

• Internal Medicine Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.