Active NPI
Bart Stanley Cuderman, MD
- Surgery Physician
- Fort Myers, FL
National Provider Identifier
1649413907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 16936
- Practice address
- 14640 Double Eagle CT
Fort Myers, FL 33912-1716 - Phone
- (239) 561-6488
- NPI assigned
- Apr 15, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 16936 | MN | Primary |
Addresses
Primary practice location
14640 Double Eagle CT
Fort Myers, FL 33912-1716
Mailing address
14640 Double Eagle CT
Fort Myers, FL 33912-1716
Phone (239) 561-6488
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16936 | MN | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239753600000",
"number": "1649413907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14640 DOUBLE EAGLE CT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339121716",
"telephone_number": "239-561-6488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14640 DOUBLE EAGLE CT",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339121716",
"telephone_number": "239-561-6488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUDERMAN",
"first_name": "BART",
"middle_name": "STANLEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-15",
"last_updated": "2009-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "16936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.