Individual provider Active NPI

Douglas Michael Stevens, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1952373367
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
ME0068103 Issued in FL
Practice address
9711 Commerce Center CT Ste 101
Fort Myers, FL 33908-3817
Phone
(239) 939-2621
Fax
(239) 939-3875
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X ME0068103 FL Primary

Addresses

Primary practice location

9711 Commerce Center CT Ste 101
Fort Myers, FL 33908-3817

Mailing address

9711 Commerce Center CT Ste 101
Fort Myers, FL 33908-3817
Phone (239) 939-2621

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000367 FL Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 7810958733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Albany Medical College of Union University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates MD PAGroup PAC ID 2567528011, 6 clinicians

Practice addresses (Care Compare)

9711 Commerce Ctr CT
Suite 101
Fort Myers, FL 33908-3817
Phone (239) 939-2621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0068103FLMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Associates MD PA CurrentSince Nov 1, 2019 Accepting new patients

Locations

9711 Commerce Center Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 939-2621

9711 Commerce Center Ct
#10
Fort Myers, FL 33908
Phone (239) 939-2621

Organizations & group practices 1

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 3

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1952373367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 COMMERCE CENTER CT STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083817",
            "telephone_number": "239-939-2621",
            "fax_number": "239-939-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 COMMERCE CENTER CT STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083817",
            "telephone_number": "239-939-2621",
            "fax_number": "239-939-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "DOUGLAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME0068103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.