BANAFSHEH KIANKHOOY FARD M.D.
NPI 1174819395
Pediatrics - Adolescent Medicine in Fort Myers, FL

Q: What is Banafsheh Kiankhooy Fard's NPI number?

The NPI number for Banafsheh Kiankhooy Fard is 1174819395. It was assigned to this individual provider in the NPPES registry on June 27, 2011.

Q: What is Banafsheh Kiankhooy Fard's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Active since June 27, 2011PECOS Enrolled

2780 CLEVELAND AVE STE 709, FORT MYERS, FL 33901(239) 343-3831(239) 343-2301 Get Directions Write a Review

NPPES record last updated: May 17, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Banafsheh Kiankhooy Fard M.d. NPPES

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

BANAFSHEH KIANKHOOY FARD M.D. (NPI 1174819395) is an individual adolescent medicine provider in Fort Myers, Florida, licensed in Florida (ME119702) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174819395

Entity TypeIndividualFemale

Primary Taxonomy2080A0000X

Provider Legal NameBANAFSHEH KIANKHOOY FARDCredential: M.D.

Location Address2780 CLEVELAND AVE STE 709Fort Myers, FL 33901-5857

Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-3831 · Fax (239) 343-2301

Phone(239) 343-3831

Fax(239) 343-2301

Sole ProprietorNo

Enumeration DateJune 27, 2011

Last NPPES UpdateMay 17, 2018

✔ NPI 1174819395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in FL · ME119702

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

2780 CLEVELAND AVE STE 709, Fort Myers, FL 33901

Open in Google Maps ↗

Other Identifiers 1

OtherME119702FL · License

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Banafsheh Kiankhooy Fard M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

Medicare enrollment records show Banafsheh Kiankhooy Fard reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lee Memorial Health System

Same address

Emergency Medicine

2780 CLEVELAND AVE, SUITE 705
Fort Myers, FL 33901

Reassigned Medicare billing, Florida enrollment
1,345 clinicians in this Medicare group

NPI 1134222532 (239) 334-5244

Lee Health System Inc

8.6 mi

Internal Medicine

9981 S HEALTHPARK DR
Fort Myers, FL 33908

Reassigned Medicare billing, Florida enrollment
1,899 clinicians in this Medicare group

NPI 1942058557 (239) 424-1500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

EVE SUMMER REID D.O.

Family Medicine