Deetta L Depiro, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN9277422 Issued in FL

Practice address

126 Del Prado Blvd N Ste 104
Cape Coral, FL 33909-2713

Phone

(239) 573-1606

Fax

(239) 573-1044

NPI assigned

Jul 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Deetta Debault Former name

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

Specialty

Nurse Practitioner

Education

University of South Florida College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: deetta.debault.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD

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

• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1477960888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019328",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 DEL PRADO BLVD N STE 104",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092713",
            "telephone_number": "239-573-1606",
            "fax_number": "239-573-1044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339013717",
            "country_code": "US",
            "telephone_number": "239-344-2330",
            "fax_number": "239-332-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPIRO",
        "first_name": "DEETTA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9277422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012471200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEETTA",
            "last_name": "DEBAULT",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dental Associates of Cape Coral, PA
• Dental Sleep Medicine of Southwest Florida LLC
• Dental Specialty Center of Cape Coral
• Dentists on Pine Island, P.a.
• Jameson Depaola, MS
• David Nelson Depree, MD
• Rachael Leigh Derosso
• Kelly Nicole Derwick, RDN, LN
• Hemal Desai, PHARMD
• Pratik Desai, M.D.

• Gerontology Nurse Practitioner in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.