Therese Dessoye, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9114915 Issued in FL

Practice address

13340 Metro Pkwy Ste 400
Fort Myers, FL 33966-4818

Phone

(239) 343-1105

Fax

(239) 343-1106

NPI assigned

Sep 15, 2021

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

Other identifiers 1

Electronic endpoints 1

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Advanced Physical Therapy and Rehab of Cape Coral LLCGroup PAC ID 1951439660, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: tdessoye276318@direct.leememorial.org

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.

• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment Care Compare group NPD
• Cape Coral Emergency Physicians LLC

  • Emergency Medicine Physician
  • Cape Coral, FL
  • NPI 1376611962
  Medicare reassignment
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment
• Advanced Physical Therapy & Rehab of Cape Coral, LLC

  dba Advanced Physical Therapy & Rehab

  • Physical Therapy Clinic/Center
  • Cape Coral, FL
  • NPI 1891990206
  Care Compare group
• Lee Health System Inc

  dba Lee Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  dba LCH-Golisano Peds PC Bayshore

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  dba LCH- Pediatric Ophthalmology

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1770165920
  NPD

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

• Lee Health System Inc

  dba Gulf Coast Medical Center

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1538839212",
    "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": "239-343-1105",
            "fax_number": "239-343-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13340 METRO PKWY STE 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664818",
            "telephone_number": "239-343-1105",
            "fax_number": "239-343-1106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3870 SE 7th Pl",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339045207",
            "country_code": "US",
            "telephone_number": "734-634-9078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESSOYE",
        "first_name": "THERESE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112123000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdessoye276318@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "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": []
}

• Mark Desomma, PA
• Misty Michelle Desomma, A.R.N.P.
• Laurie J Desouza, ARNP
• Joseph E Dessent IV, D.O.
• Kelsie Dessent
• Doreen Destefano
• Elta Desvaristes, PA-C
• Johnna Lynn Dettis, ARNP
• Samantha Lower Dettmar, MS
• Katherine Deutch

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.