Individual provider Active NPI

Richard Anthony Presutti, MD

  • Pediatrics Physician
  • Coral Springs, FL
National Provider Identifier
1467450874
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME22496 Issued in FL
Practice address
9750 NW 33Rd St
#216
Coral Springs, FL 33065-4042
Phone
(954) 752-8446
Fax
(954) 752-8464
NPI assigned
Jul 9, 2005
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME22496 FL Primary

Addresses

Primary practice location

9750 NW 33Rd St
#216
Coral Springs, FL 33065-4042

Mailing address

11424 Ohanu Cir
Boynton Beach, FL 33437-7031
Phone (954) 752-8446

Other identifiers 2

IdentifierTypeStateIssuer
035451100MedicaidFL
93150OtherFLBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME22496FLMDPediatrics Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1467450874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11424 OHANU CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334377031",
            "telephone_number": "954-752-8446",
            "fax_number": "954-752-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 NW 33RD ST",
            "address_2": "#216",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654042",
            "telephone_number": "954-752-8446",
            "fax_number": "954-752-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESUTTI",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-09",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME22496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035451100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "93150",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.