Individual provider Active NPI

Curtis Lee Beauregard, MD.

  • Neurological Surgery Physician
  • Ft. Myers, FL
National Provider Identifier
1730158627
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
74193 Issued in FL
Practice address
12468 Brantley Commons CT
Ft. Myers, FL 33907
Phone
(833) 863-6633
Fax
(561) 392-3793
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 37010 TN
Interventional Pain Medicine Physician 208VP0014X 37010 TN
Neurological Surgery Physician 207T00000X 74193 FL Primary

Addresses

Primary practice location

12468 Brantley Commons CT
Ft. Myers, FL 33907

Mailing address

12468 Brantley Commons CT
Ft. Myers, FL 33907
Phone (833) 863-6633

Other identifiers 1

IdentifierTypeStateIssuer
Q009492MedicaidTN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040224000251 FL Practitioner - Neurosurgery 8729974134 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
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 Medicine

State licenses

LicenseStateTypeSpecialty
37010TNMDPharmacist
74193FLMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics and Pain Management, P.L. CurrentSince Jan 14, 2018 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Southwest Neurosurgical and Spine Center LLC Neurological Surgery PastSince Oct 9, 2007 Accepting new patients

Locations

3355 Burns Rd
Ste 304
Palm Beach Gardens, FL 33410
Phone (561) 627-3336

Interoperability endpoints

  • Direct secure messaging: curtis.beauregard.1@31266.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1730158627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12468 BRANTLEY COMMONS CT",
            "city": "FT. MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "833-863-6633",
            "fax_number": "561-392-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12468 BRANTLEY COMMONS CT",
            "city": "FT. MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "833-863-6633",
            "fax_number": "561-392-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUREGARD",
        "first_name": "CURTIS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "37010",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TN",
            "license": "37010",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "74193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009492",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Myers, FL

Sources for this page

Verify at the official NPI Registry.