Individual provider Active NPI

Felix James Grucci III, DO

  • Psychiatry Physician
  • Fort Myers, FL
National Provider Identifier
1073824454
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
286656 Issued in NY
Practice address
11215 Metro Pkwy BLDG. 3 Ste1
Fort Myers, FL 33966-3244
Phone
(239) 208-2212
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 286656 NY Primary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X OS13068 FL
Psychiatry Physician 2084P0800X OS13068 FL
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 286656 NY

Addresses

Primary practice location

11215 Metro Pkwy BLDG. 3 Ste1
Fort Myers, FL 33966-3244

Mailing address

11215 Metro Pkwy BLDG. 3 Ste1
Fort Myers, FL 33966-3244
Phone (239) 208-2212

Other practice location 1

414 S Service Rd Unit 169
Patchogue, NY 11772-2254
Phone (631) 317-2172

Other identifiers 3

IdentifierTypeStateIssuer
286656-4WOtherNYWORKER'S COMPENSATION
04672437MedicaidNY
110890100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150713003221 FL Practitioner - PsychiatryPractitioner - Osteopathic Manipulative Medicine 5092028548
I20170125000728 NY Practitioner - Psychiatry 5092028548 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286656NYMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brookhaven Memorial Hospital Medical Center, Inc. Current Accepting new patients
New York University CurrentSince Nov 7, 2022 Accepting new patients
New York University CurrentSince Nov 7, 2022 Accepting new patients
Long Island Community Hospital at NYU Langone Health CurrentSince May 6, 2017 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince May 6, 2017 Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

365 E Montauk Hwy
Patchogue, NY 11772
Phone (631) 654-7370

101 Hospital Rd
Unit 1E
Patchogue, NY 11772

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

550 Montauk Hwy
Shirley, NY 11967
Phone (631) 852-1000

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1073824454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY BLDG. 3 STE1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339663244",
            "telephone_number": "239-208-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY BLDG. 3 STE1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339663244",
            "telephone_number": "239-208-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 S Service Rd Unit 169",
            "address_purpose": "LOCATION",
            "city": "Patchogue",
            "state": "NY",
            "postal_code": "117722254",
            "country_code": "US",
            "telephone_number": "631-317-2172",
            "fax_number": "631-317-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUCCI",
        "first_name": "FELIX",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "286656",
            "primary": true
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS13068",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS13068",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "286656",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "286656-4W",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04672437",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110890100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.