Individual provider Active NPI

Andrea R Kuiper, P.A.

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1295767143
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103589 Issued in FL
Practice address
8960 Colonial Center Dr Ste 302
Fort Myers, FL 33905-7810
Phone
(239) 343-9700
Fax
(239) 343-9699
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA9103589 FL Primary

Addresses

Primary practice location

8960 Colonial Center Dr Ste 302
Fort Myers, FL 33905-7810

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9700

Other practice location 1

1550 Barkley Cir
Fort Myers, FL 33907-4539
Phone (239) 938-2000

Other identifiers 3

IdentifierTypeStateIssuer
000621200MedicaidFL
P01272555OtherFLRAILROAD MCR
Y04JJOtherFLBCBS OF FL

Other names 1

  • Andrea Sensecqua Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asensecqua6870@Direct.leememorial.org Lee Memorial Health System

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070425000416 FL Practitioner - Physician Assistant 0749176808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9103589FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Nov 19, 2018 Accepting new patients
Lee Memorial Health System CurrentSince Nov 19, 2018 Accepting new patients

Locations

8960 Colonial Center Dr
Ste 302
Fort Myers, FL 33905
Phone (239) 343-9633

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

9981 S Healthpark Dr
Ste 120
Fort Myers, FL 33908
Phone (239) 343-6341

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: asensecqua6870@direct.leememorial.org

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1295767143",
    "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": "239-343-9700",
            "fax_number": "239-343-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8960 COLONIAL CENTER DR STE 302",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057810",
            "telephone_number": "239-343-9700",
            "fax_number": "239-343-9699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Barkley Cir",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339074539",
            "country_code": "US",
            "telephone_number": "239-938-2000",
            "fax_number": "239-274-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUIPER",
        "first_name": "ANDREA",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000621200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01272555",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "Y04JJ",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asensecqua6870@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SENSECQUA",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.