Active NPI
Robert Eliot Kupsaw, M.D.
- Emergency Medicine Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME48214
- Practice address
- 13778 Plantation Rd
Fort Myers, FL 33912-4301 - Phone
- (239) 343-0454
- Fax
- (239) 343-1075
- NPI assigned
- Jan 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME48214 | FL | |
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician | 207PE0005X | ME48214 | FL | |
| Emergency Medicine Physician | 207P00000X | ME48214 | FL | Primary |
Addresses
Primary practice location
13778 Plantation Rd
Fort Myers, FL 33912-4301
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-0454
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1492 | Other | FL | BLUE CROSS BLUE SHIELD |
| 043729800 | Medicaid | FL | |
| 221870 | Other | FL | AMERIGROUP |
| 297506 | Other | FL | AVMED |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rkupsaw5050@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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Connecticut School of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900
13778 Plantation Rd
Fort Myers, FL 33912-4301
Phone (239) 343-0454
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Hospital & facility affiliations
- Empath Home Health
- Preferred Care Home Health Services
- Trilogy Home Healthcare
- Millennium Home Care LLC
- Haven Home Health Care
- Lee Memorial Hospital
- Cape Coral Hospital
- Gulf Coast Medical Center Lee Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 89 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Health System Inc | Family Medicine | Current | Accepting new patients |
| Lee Memorial Health System | Family Medicine | Current | Accepting new patients |
| All X Ray Diagnostic Services Corp | Past | Accepting new patients | |
| Cape Coral Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344
1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700
13778 Plantation Rd
Fort Myers, FL 33912
Phone (239) 343-0454
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- rkupsaw5050@direct.leememorial.org
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
Family Medicine
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
-
- Clinic/Center
- Miami, FL
- NPI 1659399574
-
- Emergency Medicine Physician
- Cape Coral, FL
- NPI 1225093941
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Fort Myers, FL
- NPI 1376517862
-
- Home Health Agency
- Fort Myers, FL
- NPI 1659675106
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1366281750
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1427806025
-
- General Acute Care Hospital
- Cape Coral, FL
- NPI 1780429076
-
- Home Health Agency
- Venice, FL
- NPI 1518429166
-
- Home Health Agency
- Port Charlotte, FL
- NPI 1700058583
-
- Home Health Agency
- Fort Myers, FL
- NPI 1245409010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1316004484",
"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": "239-343-0454",
"fax_number": "239-343-1075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13778 PLANTATION RD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124301",
"telephone_number": "239-343-0454",
"fax_number": "239-343-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPSAW",
"first_name": "ROBERT",
"middle_name": "ELIOT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-01",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME48214",
"primary": false
},
{
"code": "207PE0005X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
"state": "FL",
"license": "ME48214",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME48214",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1492",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043729800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "221870",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "297506",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rkupsaw5050@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": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.