Individual provider Active NPI

Diane L Pugh, DO

  • Family Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1073590667
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0006117 Issued in FL
Practice address
1215 S 25TH St
Fort Pierce, FL 34947-4702
Phone
(772) 468-5925
NPI assigned
Dec 27, 2005
Last updated
Feb 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0006117 FL Primary

Addresses

Primary practice location

1215 S 25TH St
Fort Pierce, FL 34947-4702

Mailing address

6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051
Phone (305) 500-2000

Other identifiers 1

IdentifierTypeStateIssuer
OS0006117OtherFLMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diane.pugh.1@29601.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100223000679 FL Practitioner - Family Practice 3476697855 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

1987 S US Hwy 1
Fort Pierce, FL 34950-5147
Phone (772) 468-5925

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0006117FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mehan Medical Consulting LLC CurrentSince Jan 15, 2019 Accepting new patients
Inpatient Consultants of Florida, Inc Current Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Oct 1, 2015 Accepting new patients
Metcare of Florida, Inc CurrentSince Mar 1, 2021 Accepting new patients
Conviva Medical Center Management LLC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Metcare of Florida, Inc CurrentSince Mar 1, 2021 Accepting new patients
Metcare of Florida Past Accepting new patients

Locations

1215 S 25th St
Fort Pierce, FL 34947
Phone (772) 468-5925

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

478 NE Alice St
Jensen Beach, FL 34957

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

1430 SW Saint Lucie West Blvd
Ste 101
Port St Lucie, FL 34986
Phone (772) 877-3591

1700 SE Hillmoor Dr
Ste 500
Port St Lucie, FL 34952
Phone (772) 335-3200

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

509 SE Riverside Dr
Ste 200
Stuart, FL 34994
Phone (772) 219-4026

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 7

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 7

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1073590667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474702",
            "telephone_number": "772-468-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0006117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS0006117",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane.pugh.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1215 S 25th St",
            "city": "Fort Pierce",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349474702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.