IVAN L MAZZORANA JR MD PA
NPI 1790877488
Psychiatry & Neurology - Psychiatry in Ft Myers, FL
About Ivan L Mazzorana Jr Md Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IVAN L MAZZORANA JR MD PA (NPI 1790877488) is a healthcare organization registered as a psychiatry in Ft Myers, Florida and active in the NPI registry since September 2006. The organization lists Ivan L Mazzorana, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ivan L Mazzorana Jr Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
14Medicare enrollment records show 14 clinicians reassign Medicare billing to Ivan L Mazzorana Jr MD PA, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 13 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (14)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently 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 Ivan L Mazzorana Jr MD PA's NPI number?
The NPI number for Ivan L Mazzorana Jr MD PA is 1790877488. It was assigned to this organization in the NPPES registry on September 29, 2006.
Where is Ivan L Mazzorana Jr MD PA located?
Ivan L Mazzorana Jr MD PA is located at 12590 Whitehall Dr Suite 3, Ft Myers, FL 33907. The listed phone number is (239) 939-9090.
What is Ivan L Mazzorana Jr MD PA's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Ivan L Mazzorana Jr MD PA enrolled in Medicare?
Yes. Ivan L Mazzorana Jr MD PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ivan L Mazzorana Jr MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 5 Medicare specialties reassign their Medicare billing to Ivan L Mazzorana Jr MD PA. 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. The largest specialties are Clinical Social Worker (7), Nurse Practitioner (4) and Certified Clinical Nurse Specialist (CNS) (1). Of these, 11 practice at this address and 13 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Ivan L Mazzorana Jr MD PA accept?
Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Ivan L Mazzorana Jr MD PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ivan L Mazzorana Jr MD PA was last updated on November 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.
# Ivan L Mazzorana Jr Md Pa · NPI 1790877488
Psychiatry organization in Ft Myers, Florida. Organization record, active in the CMS NPPES registry since September 29, 2006.
## Identity
- **NPI:** 1790877488 (Entity type: Organization)
- **Enumerated:** September 29, 2006
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **Organization subpart:** No
- **Authorized official:** Ivan Mazzorana, PRESIDENT
## Practice location
- **Address:** 12590 WHITEHALL DR, SUITE 3, Ft Myers, FL 33907-3620
- **Phone:** (239) 939-9090 · **Fax:** (239) 939-2922
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 14 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (7), Nurse Practitioner (4), Certified Clinical Nurse Specialist (CNS) (1); 11 practice at this address and 13 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 15, 2012
- **Other identifiers:** Other 990014183; Other 3189574; Medicare PIN K4741 (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1790877488) · Data from the CMS NPPES public registry.