Individual provider Active NPI

Celeste M. Correa, M.D.

  • Family Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1114909926
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1064131778 Issued in AZ
Practice address
636 Del Prado Blvd S Ste A5510
Cape Coral, FL 33990
Phone
(239) 343-9237
Fax
(239) 343-9218
NPI assigned
Nov 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME133995 FL
Family Medicine Physician 207Q00000X 1064131778 AZ Primary

Addresses

Primary practice location

636 Del Prado Blvd S Ste A5510
Cape Coral, FL 33990

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-5537

Other identifiers 2

IdentifierTypeStateIssuer
451964MedicaidAZ
023068200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040423001375 AZ Practitioner - Family PracticePractitioner - Emergency Medicine 7810980117 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1064131778AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC Family Medicine Current Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Mar 9, 2015 Accepting new patients
Squaw Peak Family Physicians PC Family Medicine Current Accepting new patients
Honorhealth Medical Group, LLC Current Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Mar 9, 2015 Accepting new patients
Alberti-Correa Family Medicine, PC Past Accepting new patients
Willard Emergency Physicians Past Accepting new patients
Lee Health System Inc Past Accepting new patients
Verde Valley Medical Center Past Accepting new patients
Oracle Healthcare Family Medicine Past Accepting new patients
Centro de Medicina de Familia de Cayey Family Medicine PastSince Jul 6, 1990 Accepting new patients

Locations

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

4712 E Dynamite Blvd
Cave Creek, AZ 85331
Phone (480) 342-8711

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

9327 N 3rd St
Ste 100
Phoenix, AZ 85020
Phone (602) 371-3100

18404 N Tatum Blvd
Ste 101
Phoenix, AZ 85032
Phone (602) 992-1900

1610 W Glendale Ave
#128
Phoenix, AZ 85021
Phone (623) 780-1999

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1114909926",
    "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": "239-343-5537",
            "fax_number": "239-343-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 DEL PRADO BLVD S STE A5510",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "telephone_number": "239-343-9237",
            "fax_number": "239-343-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "CELESTE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME133995",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1064131778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451964",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023068200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.