Individual provider Active NPI

Peter Perou, RPA-C

  • Physician Assistant
  • Estero, FL
National Provider Identifier
1033345780
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120012 Issued in FL
Practice address
23450 Via Coconut PT
Estero, FL 34135-1877
Phone
(239) 343-9696
Fax
(239) 343-4054
NPI assigned
Jun 9, 2009
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9120012 FL Primary
Surgical Physician Assistant 363AS0400X 011081 NY

Addresses

Primary practice location

23450 Via Coconut PT
Estero, FL 34135-1877

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9696

Other practice location 1

1095 Park Ave
New York, NY 10128-1154
Phone (212) 427-7750

Other identifiers 1

IdentifierTypeStateIssuer
130336700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pperou709117@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110912000016 NY Practitioner - Physician Assistant 9830360429 Reassigns benefits to 4 organizations
I20260302001016 FL Practitioner - Physician Assistant 9830360429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

210 E 64TH St
New York, NY 10065-7471

23450 Via Coconut PT
Estero, FL 34135-1877
Phone (239) 424-1449

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

515 W 36TH St
FL 6
New York, NY 10018-1245
Phone (212) 434-2279

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9120012FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 1, 2023 Accepting new patients
New York University CurrentSince Dec 13, 2016 Accepting new patients
New York University CurrentSince Dec 13, 2016 Accepting new patients
Lee Health System Inc CurrentSince Mar 25, 2025 Accepting new patients
Lee Health System Inc CurrentSince Mar 25, 2025 Accepting new patients
Ryc Orthopaedics, PC CurrentSince Sep 1, 2013 Accepting new patients
Manhattan Orthopaedics, P.C. Past Accepting new patients

Locations

23450 Via Coconut Pt
Estero, FL 34135
Phone (239) 468-0150

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

1056 5th Ave
New York, NY 10028
Phone (212) 348-3636

130 E 77th St
#7
New York, NY 10075
Phone (212) 744-8115

130 E 77th St
Fl 7
New York, NY 10075
Phone (212) 744-8114

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: peter.perou@direct.hobokenumc.md
  • Direct secure messaging: pperou70030@northwell.direct-ci.com
  • Direct secure messaging: pperou709117@direct.leememorial.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1033345780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9696",
            "fax_number": "239-343-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23450 VIA COCONUT PT",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341351877",
            "telephone_number": "239-343-9696",
            "fax_number": "239-343-4054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1095 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101281154",
            "country_code": "US",
            "telephone_number": "212-427-7750",
            "fax_number": "212-427-7759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEROU",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120012",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130336700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pperou709117@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

Verify at the official NPI Registry.