NICHOLAS JOHN JR. NEWBOLD (ARNP) – Gerontology Nurse Practitioner, NPI 1417457425
Gerontology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for NICHOLAS JOHN JR. NEWBOLD (ARNP)
21297 OLEAN BLVD STE A
PORT CHARLOTTE, FL 339526704
Phone: (855) 979-5700
Type: Location
1390 Grand Venture Dr
North Port, FL 342862309
Phone: (941) 257-2280
Fax: (941) 423-8946
Type: Location
Winkler Avenue, Fort Myers, Lee County, Florida, 33966, United States
FORT MYERS, FL 339019342
Phone: (877) 856-5774
Type: Mailing
PO BOX 102222
ATLANTA, GA 303682222
Phone: (239) 274-8200
Type: Mailing
22395 EDGEWATER DR
PORT CHARLOTTE, FL 339802012
Phone: (941) 766-7222
Fax: (941) 766-0970
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $144.
Total Amount is formed as General ($144) + Research ($0) + Ownership ($0) = $144.
Last reported payment date: 2024-10-16 • Largest payer in this snapshot: Janssen Biotech, Inc. ($30).
Total Amount
$144
General + Research + Ownership
Payments
7
Total payment records
General Amount
$144
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Biotech, Inc. | $30 |
| Daiichi Sankyo Inc. | $29 |
| SOBI, INC | $27 |
| Eisai Inc. | $23 |
| Merck Sharp & Dohme LLC | $19 |
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: 2018-08-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20180822001598 | I | Nurse Practitioner | FL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33952)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Medical Oncology | FL | |
| Medical Oncology, Hematology/Oncology | FL | |
| H E M A T O L O G Y/ O N C O L O G Y | FL | |
| H E M A T O L O G Y/ O N C O L O G Y | FL | |
| Internal Medicine, Hematology/Oncology | FL | |
| - | GA | |
| Hematology/Oncology, Internal Medicine | GA | |
| H E M A T O L O G Y/ O N C O L O G Y | FL | |
| Hospice/Palliative Care, Internal Medicine | FL | |
| H E M A T O L O G Y/ O N C O L O G Y | GA |
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