Individual provider Active NPI

Sue A Dupont, PT ATC

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1215910666
Registry record updated Jul 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 11530 Issued in FL
Practice address
4223 SE 3Rd Ave
Cape Coral, FL 33904-8400
Phone
(239) 540-3837
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 11530 FL Primary
Athletic Trainer 2255A2300X AL271 FL

Addresses

Primary practice location

4223 SE 3Rd Ave
Cape Coral, FL 33904-8400

Mailing address

4223 SE 3Rd Ave
Cape Coral, FL 33904-8400
Phone (239) 540-3837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230110000491 FL Practitioner - Physical Therapist in Private Practice 0244600153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8660 College Pkwy
Suite 250
Fort Myers, FL 33919-5817
Phone (941) 841-9591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 11530FLMDPhysical Therapist
AL271FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Align PT and Pilates LLC Physical Therapist CurrentSince Nov 22, 2022 Accepting new patients
Florida Musculoskeletal Surgical Group LLC Past Accepting new patients
Tampa Bay Orthopaedic Specialists Past Accepting new patients

Locations

8192 College Pkwy
Ste A9
Fort Myers, FL 33919

8660 College Pkwy
Ste 250
Fort Myers, FL 33919
Phone (941) 841-9591

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5077/brand/3/csg/61/fhir/r4

Organizations & group practices 3

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468627200000",
    "number": "1215910666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4223 SE 3RD AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048400",
            "telephone_number": "239-540-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4223 SE 3RD AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048400",
            "telephone_number": "239-540-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "SUE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PT ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2016-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 11530",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.