MR. HARVEY WILLIS JR. PUTNAM (PA) – Physician Assistant, NPI 1003868761
Physician Assistant
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,458 PHYSICIAN ASSISTANT in SC
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Provider Addresses for MR. HARVEY WILLIS JR. PUTNAM (PA)
2234, Colonial Boulevard, Fort Myers, Lee County, Florida, 33907, United States
ATTN: PAYER CONTRACTING & RELATIONS
FORT MYERS, FL 339071412
Phone: (239) 931-7342
Fax: (239) 931-7385
Type: Mailing
East Highway 76, Mullins, Marion County, South Carolina, 29574, United States
SUITE 3
MULLINS, SC 295746038
Phone: (843) 423-0230
Fax: (843) 423-0802
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 57 Open Payments records for all available years, with a total value of $1,139.
Total Amount is formed as General ($1,139) + Research ($0) + Ownership ($0) = $1,139.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($323).
Total Amount
$1,139
General + Research + Ownership
Payments
57
Total payment records
General Amount
$1,139
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Sumitomo Pharma America, Inc. | $323 |
| Endo Pharmaceuticals Inc. | $287 |
| Endo USA, Inc. | $84 |
| ABBVIE INC. | $84 |
| Axonics, Inc. | $50 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-11-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060130000897 | I | Physician Assistant | SC | TBD |
| I20141107001922 | I | Physician Assistant | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J9030 | Bcg live intravesical instillation, 1 mg | 4,850 | 21 | $0 |
| J0897 | Injection, denosumab, 1 mg | 3,360 | 14 | $0 |
| 81003 | Automated urinalysis test | 2,614 | 1,405 | $0 |
| J9155 | Injection, degarelix, 1 mg | 2,560 | 11 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,307 | 796 | $0 |
Insurance plans in this area (ZIP 33907)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | SC | 51798 | Ultrasound measurement of bladder capacity after voiding | 53 | 41 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease, Critical Care (Intensivists) | NY | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| General Surgery | SC | |
| Physician Assistant | SC | |
| Nurse Practitioner | SC | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | SC | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| Orthopedic Surgery | SC | |
| Family Practice | SC | |
| Physician Assistant | SC |
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