KELLY COSTOPOULOS BASS MD
NPI 1134626807
Internal Medicine - Cardiovascular Disease in Fort Myers, FL

Q: What is Kelly Bass's NPI number?

The NPI number for Kelly Bass is 1134626807. It was assigned to this individual provider in the NPPES registry on April 10, 2018. The provider is also known as Kelly Costopoulos MD..

Q: What is Kelly Bass's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Bass was last updated on August 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 10, 2018PECOS EnrolledAccepts Medicare Assignment

9800 S HEALTHPARK DR STE 320, FORT MYERS, FL 33908(239) 343-6350(239) 343-4738 Get Directions Write a Review

NPPES record last updated: August 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 9, 2024, Jun 22, 2024, May 8, 2024 and 1 more (4 updates tracked since 2018).

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About Kelly Costopoulos Bass Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY COSTOPOULOS BASS MD (NPI 1134626807) is an individual cardiovascular disease provider in Fort Myers, Florida, licensed in Florida (ME168153) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS, is affiliated with Lee Memorial Hospital, and maintains a secondary practice location in Nashville.

NPPES Registry Identity

NPI1134626807

Entity TypeIndividualFemale

Primary Taxonomy207RC0000X

Provider Legal NameKELLY COSTOPOULOS BASSCredential: MD

Location Address9800 S HEALTHPARK DR STE 320Fort Myers, FL 33908-3630

Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-6350 · Fax (239) 343-4738

Phone(239) 343-6350

Fax(239) 343-4738

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 10, 2018

Last NPPES UpdateAugust 9, 20244 updates tracked since enumeration

NPPES CertifiedAugust 9, 2024

✔ NPI 1134626807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in FL · ME168153

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

9800 S HEALTHPARK DR STE 320, Fort Myers, FL 33908

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Other Names 1

Former Name (1)Kelly Costopoulos Md.

Secondary Practice Location 1

Location 11161 21st Ave South, D3100 Medical Center NorthNashville, TN 37232 · Phone (615) 322-0417

Other Identifiers 1

Medicaid122322800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Costopoulos Bass Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789128760

PECOS Enrollment IDI20240701003932

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

32 services32 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

28 services28 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

26 services21 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

25 services12 patients

3d radiographic procedure 76376

A 3D radiographic procedure is a non-invasive imaging test that helps doctors visualize the internal structures of your body in three dimensions. This advanced technology provides detailed images, aiding in accurate diagnosis and treatment planning. It involves exposure to minimal radiation.

22 services22 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

17 services17 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lee Memorial Hospital

Acute Care Hospitals · Fort Myers, FL

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100012

Location2776 Cleveland AveFort Myers, FL 33901 · Lee County

Emergency services Birthing friendly

Gulf Coast Medical Center Lee Health

Acute Care Hospitals · Fort Myers, FL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100220

Location13681 Doctors WayFort Myers, FL 33912 · Lee County

Emergency services

Cape Coral Hospital

Acute Care Hospitals · Cape Coral, FL

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100244

Location636 Del Prado BlvdCape Coral, FL 33990 · Lee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33908 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$135.56 typical visit price

range $58.56 – $179.05

Typical copayment $33.89 (range $14.64 – $44.76)

Most-billed visit code 99204

Established Patient

$73.00 typical visit price

range $18.44 – $144.68

Typical copayment $18.25 (range $4.61 – $36.17)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RIZCALLAH DIDIER DEEK MD

Internal Medicine (Cardiovascular Disease)