Individual provider Active NPI

Yesenia Altagracia Martinez Regalado, MD

  • Family Medicine Physician
  • Lehigh Acres, FL
National Provider Identifier
1962848333
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME117111 Issued in FL
Practice address
5700 Lee Blvd
Lehigh Acres, FL 33971
Phone
(239) 482-1010
Fax
(239) 477-5490
NPI assigned
May 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME117111 FL Primary

Addresses

Primary practice location

5700 Lee Blvd
Lehigh Acres, FL 33971

Mailing address

12730 New Brittany Blvd Ste 602
Fort Myers, FL 33907-4690
Phone (239) 275-5522

Other identifiers 1

IdentifierTypeStateIssuer
009392800MedicaidFL

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
I20131010001712 FL Practitioner - Family Practice 2264666098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5700 Lee Blvd
Lehigh Acres, FL 33971-6355
Phone (239) 477-5491

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Primary Care of Southwest Florida PL Family Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

1265 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 573-7337

1255 Viscaya Pkwy
Ste 200
Cape Coral, FL 33990
Phone (239) 574-1988

12730 New Brittany Blvd
Ste 602
Fort Myers, FL 33907
Phone (239) 275-5522

12730 New Brittany Blvd
Ste 200
Fort Myers, FL 33907
Phone (239) 275-5857

5700 Lee Blvd
Lehigh Acres, FL 33971
Phone (239) 481-5437

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 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": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1962848333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 NEW BRITTANY BLVD STE 602",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074690",
            "telephone_number": "239-275-5522",
            "fax_number": "239-275-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 LEE BLVD",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "33971",
            "telephone_number": "239-482-1010",
            "fax_number": "239-477-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ REGALADO",
        "first_name": "YESENIA",
        "middle_name": "ALTAGRACIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME117111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009392800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.