Active NPI
Danielle Marie Bakalar, PA
- Physician Assistant
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9109626
- Practice address
- 2621 Cleveland Ave
Fort Myers, FL 33901-5802 - Phone
- (239) 425-1270
- Fax
- (239) 479-7708
- NPI assigned
- Dec 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9109626 | FL | Primary |
Addresses
Primary practice location
2621 Cleveland Ave
Fort Myers, FL 33901-5802
Mailing address
15051 S Tamiami TRL
Suite 203
Fort Myers, FL 33908-5182
Phone (239) 437-8810
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075
3268 Forum Blvd
Suite 201
Fort Myers, FL 33905-5585
Phone (239) 232-1176
7331 Gladiolus Dr
Fort Myers, FL 33908-5101
Phone (239) 437-8810
9400 Gladiolus Dr
Suite 320
Fort Myers, FL 33908-9622
Phone (239) 482-7546
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Naples Center for Dermatology & Riverchase Dermatology | Current | Accepting new patients |
Locations
413 Del Prado Blvd S
Ste 101
Cape Coral, FL 33990
Phone (239) 443-1500
3268 Forum Blvd
Ste 201
Fort Myers, FL 33905
Phone (239) 232-1176
7331 Gladiolus Dr
Fort Myers, FL 33908
Phone (239) 437-8810
15051 S Tamiami Trl
Ste 203
Fort Myers, FL 33908
Phone (239) 732-5959
2621 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 220-5561
1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- dbakalar@aquadermatology.emadirect.md
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.
-
- Dermatology Physician
- Palm Beach Gardens, FL
- NPI 1538270335
-
- Durable Medical Equipment & Medical Supplies
- Cape Coral, FL
- NPI 1538645775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479859200000",
"number": "1902142599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15051 S TAMIAMI TRL",
"address_2": "SUITE 203",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339085182",
"telephone_number": "239-437-8810",
"fax_number": "239-313-2555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2621 CLEVELAND AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339015802",
"telephone_number": "239-425-1270",
"fax_number": "239-479-7708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKALAR",
"first_name": "DANIELLE",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2016-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9109626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.