Individual provider Active NPI

Sherry Farag, M.D.

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1982045316
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125900 Issued in FL
Practice address
15750 New Hampshire CT Ste D
Fort Myers, FL 33908-4100
Phone
(239) 395-2434
Fax
(239) 395-2494
NPI assigned
Jul 14, 2013
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 ME125900 FL Primary

Addresses

Primary practice location

15750 New Hampshire CT Ste D
Fort Myers, FL 33908-4100

Mailing address

15750 New Hampshire CT Ste D
Fort Myers, FL 33908-4100
Phone (239) 395-2434

Other identifiers 1

IdentifierTypeStateIssuer
017937400MedicaidFL

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
I20160719002707 FL Practitioner - Family Practice 9234422833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15750 New Hampshire CT
Suite D
Fort Myers, FL 33908-4100
Phone (239) 395-2434

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Aug 23, 2021 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Aug 23, 2021 Accepting new patients
Regalmed PLLC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

9500 Bonita Beach Rd SE
Ste 302
Bonita Springs, FL 34135
Phone (239) 319-2201

13691 Metro Pkwy
Ste 110B
Fort Myers, FL 33912
Phone (239) 236-7780

15750 New Hampshire Ct
Ste D
Fort Myers, FL 33908
Phone (239) 395-2434

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

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

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

713 E Marion Ave
Ste 129
Punta Gorda, FL 33950
Phone (941) 621-2895

Interoperability endpoints

  • Direct secure messaging: sherry.farag.1@13798.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1373760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1982045316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15750 NEW HAMPSHIRE CT STE D",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084100",
            "telephone_number": "239-395-2434",
            "fax_number": "239-395-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15750 NEW HAMPSHIRE CT STE D",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084100",
            "telephone_number": "239-395-2434",
            "fax_number": "239-395-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAG",
        "first_name": "SHERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-14",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017937400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.