Keith S. Susko, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME85368 Issued in FL

Practice address

4977 Royal Gulf Cir
Fort Myers, FL 33966-7006

Phone

(239) 226-0077

Fax

(239) 489-0077

NPI assigned

Apr 5, 2006

Last updated

Sep 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Physical Medicine and RehabilitationAlso: General Practice, Pain Management

Education

Eastern Virginia Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Larsen Health Center Nursing home, Fort Myers, FL, CCN 105966

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Pain Relief and Physical Rehab Inc

  dba Pain Relief and Physical Rehab

  • Physical Medicine & Rehabilitation Physician
  • Fort Myers, FL
  • NPI 1134378938
  Medicare reassignment NPD Authorized official
• Hope Hospice and Community Services, Inc

  dba Hope Comfort Care Program

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1114225745
  Medicare reassignment NPD
• Sypert Institute PA

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Cape Coral, FL
  • NPI 1104889534
  NPD (past)
• Sypert Institute PA

  • Physical Medicine & Rehabilitation Physician
  • Bonita Springs, FL
  • NPI 1699960435
  NPD (past)

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

• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• The Christian & Missionary Alliance Foundation Inc

  dba Shell Point Nursing Pavilion

  • Skilled Nursing Facility
  • Fort Myers, FL
  • NPI 1669546321

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1275595159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339290222",
            "telephone_number": "239-226-0077",
            "fax_number": "239-489-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4977 ROYAL GULF CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339667006",
            "telephone_number": "239-226-0077",
            "fax_number": "239-489-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSKO",
        "first_name": "KEITH",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME85368",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME85368",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "17033",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "17033X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2658666-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Surgicare Center
• Surgicare Center LLC
• Susan R King PSYD PA
• Susan Support Services
• Susana Izquierdo Therapy Solutions, LLC
• Morgan Elise Sutherland
• Lucinda Sutton
• Inesa Sviridova, PA
• SW Florida Anesthesia Services LLC
• SW Florida Radiology LLC

• Physical Medicine & Rehabilitation Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.