PINNACLE PROVIDER GROUP LLC
NPI 1497646285
Nurse Practitioner - Primary Care in Fort Myers, FL
About Pinnacle Provider Group Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PINNACLE PROVIDER GROUP LLC (NPI 1497646285) is a healthcare organization registered as a primary care in Fort Myers, Florida and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through October 28, 2027 and lists Jimi Williamceau, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pinnacle Provider Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Pinnacle Provider Group LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2333026
Pinnacle Provider Group LLC · Fort Myers, FLFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Pinnacle Provider Group LLC's NPI number?
The NPI number for Pinnacle Provider Group LLC is 1497646285. It was assigned to this organization in the NPPES registry on July 10, 2025.
Where is Pinnacle Provider Group LLC located?
Pinnacle Provider Group LLC is located at 15050 Elderberry Ln, Fort Myers, FL 33907. The listed phone number is (239) 537-1260.
What is Pinnacle Provider Group LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Pinnacle Provider Group LLC enrolled in Medicare?
Yes. Pinnacle Provider Group LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pinnacle Provider Group LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Pinnacle Provider Group LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pinnacle Provider Group LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2333026) is associated with this NPI, valid through October 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Pinnacle Provider Group LLC was last updated on July 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pinnacle Provider Group Llc · NPI 1497646285
Primary Care organization in Fort Myers, Florida. Organization record, active in the CMS NPPES registry since July 10, 2025.
## Identity
- **NPI:** 1497646285 (Entity type: Organization)
- **Enumerated:** July 10, 2025
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Jimi Williamceau, OWNER
## Practice location
- **Address:** 15050 ELDERBERRY LN, Fort Myers, FL 33907-8504
- **Phone:** (239) 537-1260
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 10, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1497646285) · Data from the CMS NPPES public registry.