Individual provider Active NPI

Roshan K Vatthyam, MD

  • Clinical Cardiac Electrophysiology Physician
  • Fort Myers, FL
National Provider Identifier
1992967319
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME109924 Issued in FL
Practice address
9800 S Health Park Drive
Suite 320
Fort Myers, FL 33908-3630
Phone
(239) 343-6350
Fax
(239) 343-6358
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME109924 FL
Cardiovascular Disease Physician 207RC0000X ME109924 FL
Clinical Cardiac Electrophysiology Physician 207RC0001X ME109924 FL Primary

Addresses

Primary practice location

9800 S Health Park Drive
Suite 320
Fort Myers, FL 33908-3630

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6350

Other identifiers 3

IdentifierTypeStateIssuer
003857000MedicaidFL
000000614311OtherINANTHEM BCBS
200938050MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rvatthyam37537@Direct.leememorial.org Lee Memorial Health System

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
I20110825000700 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 3072663186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

16261 Bass Rd
Suite 300
Fort Myers, FL 33908-3671
Phone (239) 343-6410

23450 Via Coconut PT
Estero, FL 34135-1877
Phone (239) 468-0120

708 Del Prado Blvd S
Cape Coral, FL 33990-2676

8960 Colonial Ctr Dr
Fort Myers, FL 33905-7810

9800 S Healthpark Dr
Fort Myers, FL 33908-3630

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Aug 1, 2011 Accepting new patients
Lee Health System Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Internal Medicine CurrentSince Aug 1, 2011 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

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

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

9800 S Healthpark Dr
Ste 320
Fort Myers, FL 33908
Phone (239) 343-6350

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rvatthyam37537@direct.leememorial.org

Organizations & group practices 4

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1992967319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6350",
            "fax_number": "239-343-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 S HEALTH PARK DRIVE",
            "address_2": "SUITE 320",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083630",
            "telephone_number": "239-343-6350",
            "fax_number": "239-343-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATTHYAM",
        "first_name": "ROSHAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME109924",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME109924",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME109924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003857000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000614311",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200938050",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rvatthyam37537@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.