Carissa Anne Summa, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS17127 Issued in FL

Practice address

10200 Arcos Ave Ste 201
Estero, FL 33928-3529

Phone

(239) 390-3376

Fax

(239) 333-0474

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Dermatology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Estero Dermatology and Skin Surgery Center, LLCGroup PAC ID 6103822176, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Estero Dermatology & Skin Surgery Center, LLC

  • Dermatology Physician
  • Estero, FL
  • NPI 1568481901
  Medicare reassignment Care Compare group NPD
• Associates in Medicine & Surgery LLC

  • Foot & Ankle Surgery Podiatrist
  • Fort Myers, FL
  • NPI 1386884385
  NPD (past)
• Vanguard Dermatology

  • Specialist
  • Brooklyn, NY
  • NPI 1619179009
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1376614669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 9TH ST N STE 300",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025624",
            "telephone_number": "239-444-3376",
            "fax_number": "239-316-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 ARCOS AVE STE 201",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283529",
            "telephone_number": "239-390-3376",
            "fax_number": "239-333-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMA",
        "first_name": "CARISSA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS17127",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "OS9893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Stonesifer, MD
• Bridget B Stover, NP
• Josmar Suarez, DMD
• Manuel Domingo Suarez, MD
• Suitable Enterprise Group Inc
• Sandra Brose Suzuki, LCPC
• Jenna Marie Swaney
• Brian P Sweet, DO
• Alexis Sylvia, MA, LMHC
• Tara Tallaksen

• Dermatology Physician in Estero, FL
• Providers in Estero, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.