MR. DAVID SEAN MIDDLETON PA-C
NPI 1376092973
Physician Assistant in Fort Myers, FL

NPI Status: Active since September 25, 2016

Contact Information

9711 COMMERCE CENTER CT STE 101
FORT MYERS, FL
ZIP 33908
Phone: (239) 939-2621
Fax: (239) 939-3875

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 10
Physician Assistant
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About DAVID MIDDLETON

This page provides the complete NPI Profile along with additional information for David Middleton, a primary care provider established in Fort Myers, Florida with a medical specialization in Physician Assistant and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1376092973 assigned on September 2016. The practitioner's primary taxonomy code is 363A00000X with license number PA9109807 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1376092973
Provider Name: MR. DAVID SEAN MIDDLETON PA-C
Gender: Male
Entity Type: Individual
Location Address: 9711 COMMERCE CENTER CT STE 101 FORT MYERS, FL 33908
Location Phone: (239) 939-2621
Location Fax: (239) 939-3875
Mailing Address: 9711 COMMERCE CENTER CT STE 101 FORT MYERS, FL 33908
Mailing Phone: (239) 939-2621
Mailing Fax: (239) 939-3875
Medical School Name: OTHER
Graduation Year: 2016
Is Sole Proprietor?: No
Enumeration Date: 09-25-2016
Last Update Date: 10-19-2022
Code Navigator

A primary care provider (PCP) like David Middleton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Physician Assistant
Taxonomy Code: 363A00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: PA9109807
License State: FL
Taxonomy Description: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Molina Healthcare

Bronze 4 - HMO
Bronze 8 - HMO
Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO
Silver 9 - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
UHC Bronze Standard - HMO
UHC Bronze Value ($0 Virtual Urgent Care) - HMO
UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
UHC Gold Standard - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
UHC Silver Standard - HMO
UHC Silver Standard+ (Dental + Vision) - HMO
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
21549A	OTHER (01)		GROUP MEDICARE
PH419	OTHER (01)	FL	PROVIDER MEDICARE

Medicare Participation & PECOS Enrollment Status

David Middleton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

David Middleton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 8921387879
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20161116001761
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Exam of ear using a microscope
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Removal of impacted ear wax

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.92 for a new patient copayment and $18.25 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 33908 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $91.69
Minimum New Patient Price $58.56
Maximum New Patient Price $179.05

Average New Patient Copayment $22.92
Minimum New Patient Copayment $14.64
Maximum New Patient Copayment $44.76

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $73
Minimum Established Patient Price $18.44
Maximum Established Patient Price $144.68

Average Established Patient Copayment $18.25
Minimum Established Patient Copayment $4.61
Maximum Established Patient Copayment $36.17

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Advance Care Planning	Yes	N/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Breast Cancer Screening	83%	499
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Closing the Referral Loop: Receipt of Specialist Report	32%	38
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement	Yes	N/A
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Colorectal Cancer Screening	80%	1040
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Medical Attention for Nephropathy	75%	28
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record	99%	3006
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
e-Prescribing	87%	1093
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	39%	54
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop	Yes	N/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes	Yes	N/A
Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance.
Medication Reconciliation	97%	1647
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	100%	2465
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults	97%	1062
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	30%	2027
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Influenza Immunization	97%	764
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	13%	91
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access	16%	2465
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	3%	2465
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	76%	78
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR - Adults aged >=21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL; OR - Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL
Use of High-Risk Medications in the Elderly	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	1062
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Middleton is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
LEE MEMORIAL HOSPITAL	2776 CLEVELAND AVE FORT MYERS, FL 33901	(239) 332-1111	Acute Care Hospitals
CAPE CORAL HOSPITAL	636 DEL PRADO BLVD CAPE CORAL, FL 33990	(239) 424-2000	Acute Care Hospitals

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	3	7	6	0	9	2	9	7	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	3	14	6	0	9	4	9	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 4 + 6 + 0 + 9 + 4 + 9 + 1 + 4 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 3									3

The NPI number 1376092973 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 3 providers are registered at the same or nearby location.

NPI	Name / Type	Taxonomy	Address
1568558138	DREW HORLBECK MD Individual	Otolaryngology (Otology & Neurotology)	9711 COMMERCE CENTER CT STE 101 FORT MYERS, FL 33908 (239) 939-2621
1932385010	DR. CATHY MARIE NEWMAN AUD Individual	Audiologist	9711 COMMERCE CENTER CT STE 101 FORT MYERS, FL 33908 (239) 939-2621
1952373367	DR. DOUGLAS MICHAEL STEVENS MD Individual	Otolaryngology (Otolaryngology/Facial Plastic Surgery)	9711 COMMERCE CENTER CT STE 101 FORT MYERS, FL 33908 (239) 939-2621

Frequently Asked Questions

What is Mr. David Middleton PA-C NPI number?

The NPI number assigned to this healthcare provider is 1376092973, enumerated in the NPI registry as an "individual" on September 25, 2016

Where is the provider located?

The provider is located at 9711 Commerce Center Ct Ste 101 Fort Myers, Fl 33908 and the phone number is (239) 939-2621

What is the provider specialty code?

The provider's speciality is Physician Assistant with taxonomy code 363A00000X

How many years of experience does Mr. David Middleton PA-C have?

The provider has more than 10 years of experience.

What insurance does Mr. David Middleton PA-C accept?

The provider might be accepting Accepts: Molina Healthcare, UnitedHealthcare, Medicare and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Is Mr. David Middleton PA-C registered in PECOS?

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

How much is a visit to Mr. David Middleton PA-C?

Medicare beneficiaries should expect a typical cost of $91.69 with an average copayment of $22.92 for new patient appointments. Established patients should expect a typical charge of $73 and an average copayment of 18.25. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Mr. David Middleton PA-C?

The most common procedures or services performed by this practitioner are: Diagnostic exam of nasal passages using an endoscope, Diagnostic exam of voice box using a flexible endoscope, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Exam of ear using a microscope, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes and Removal of impacted ear wax.

Is Mr. David Middleton PA-C affiliated to any hospitals?

The practitioner is affiliated to the following hospital(s): LEE MEMORIAL HOSPITAL and CAPE CORAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

This NPI record was last updated on September 25, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.

About DAVID MIDDLETON

Location Map

Specialty - Primary Taxonomy

Physician Assistant

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 8921387879

PECOS Enrollment ID: I20161116001761

Accepts Medicare Assignment? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

Diagnostic exam of nasal passages using an endoscope

Diagnostic exam of voice box using a flexible endoscope

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 30-39 minutes

Exam of ear using a microscope

New patient office or other outpatient visit, 30-44 minutes

New patient office or other outpatient visit, 45-59 minutes

Removal of impacted ear wax