Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Hanna Rae Shaw

Individual provider Physician Assistant · NPI 1720608748

Hanna Rae Shaw is a Physician Assistant in Fort Myers, Florida. Qualified in 2021, 5 years ago. Practices with Lee Health System Inc, a 1,375-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2020
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Practice location Address checks out

12700 Creekside Ln Ste 301
Fort Myers, FL 33919-3356
Phone: (239) 343-3780
Fax: (239) 343-3781
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 708 Del Prado Blvd S Ste 3, Cape Coral, FL 33990-2676 — (239) 343-9960
  • 18 Charles St, Manchester, ME 04351-0435 — (207) 557-3113

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9114423 (FL)

Record details

NPI number1720608748
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 20, 2020
Last updated in NPPESJuly 2, 2024
Certification dateJuly 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Lee Health System Inc — 1375 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Fort Myers