Individual provider Active NPI

Luz E Peguero, M.D.

  • Internal Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1760469654
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME107520 Issued in FL
Practice address
2301 Del Prado Blvd S
Cape Coral, FL 33990-4615
Phone
(239) 574-8880
Fax
(239) 574-4876
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 217674 NY
Internal Medicine Physician 207R00000X ME107520 FL Primary

Addresses

Primary practice location

2301 Del Prado Blvd S
Cape Coral, FL 33990-4615

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243

Other practice location 1

1044 State St
Schenectady, NY 12307-1508
Phone (518) 370-1441

Other identifiers 4

IdentifierTypeStateIssuer
53099AOtherNYMEDICARE PIN
331833OtherNYMEDICARE OSCAR
02995513MedicaidNY
02251105MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100915000507 NY Practitioner - Internal Medicine 4880719731 Reassigns benefits to 1 organization
I20100928000334 FL Practitioner - Internal Medicine 4880719731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1407 Viscaya Pkwy
Suite 2
Cape Coral, FL 33990-6200

Hospital & facility affiliations

  • Empath Home Health Home health agency, Fort Myers, FL, CCN 109786
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10808PRMDPharmacy Technician
ME107520FLMDInternal Medicine Physician
217674NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schenectady Family Health Services, Inc. CurrentSince Jul 7, 2018 Accepting new patients
Schenectady Family Health Services, Inc. CurrentSince Jul 7, 2018 Accepting new patients
Florida Medical Associates LLC CurrentSince Sep 4, 2023 Accepting new patients
Schenectady Family Health Services, Inc. Past Accepting new patients
Schenectady Family Health Services, Inc. Past Accepting new patients
Schenectady Family Health Services, Inc. Past Accepting new patients

Locations

2301 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 574-8880

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

1044 State St
Schenectady, NY 12307
Phone (518) 370-1441

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: luz.peguero@sl.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1760469654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339904615",
            "telephone_number": "239-574-8880",
            "fax_number": "239-574-4876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 State St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123071508",
            "country_code": "US",
            "telephone_number": "518-370-1441",
            "fax_number": "518-395-9431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEGUERO",
        "first_name": "LUZ",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "217674",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME107520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "53099A",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OSCAR",
            "identifier": "331833",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995513",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02251105",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.