Individual provider Active NPI

Denise Lynne Punger, MD

  • Family Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1851398994
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME68275 Issued in FL
Practice address
4640 S 25TH St
Fort Pierce, FL 34981-5057
Phone
(772) 466-8884
Fax
(772) 466-8832
NPI assigned
Jul 5, 2005
Last updated
Sep 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME68275 FL Primary

Addresses

Primary practice location

4640 S 25TH St
Fort Pierce, FL 34981-5057

Mailing address

4640 S 25TH St
Fort Pierce, FL 34981-5057
Phone (772) 466-8884

Other identifiers 1

IdentifierTypeStateIssuer
378728100MedicaidFL

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
I20101122000558 FL Practitioner - Family Practice 2163492240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4640 S 25TH St
Fort Pierce, FL 34981-5057
Phone (772) 466-8884

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME68275FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Punger Family Medicine, LLC Family Medicine CurrentSince Sep 23, 2013 Accepting new patients
Martin Memorial Medical Center Inc Past Accepting new patients
Coastal Care Corporation Past Accepting new patients
Martin Memorial Physician Corporation Inc Past Accepting new patients

Locations

4640 S 25th St
Fort Pierce, FL 34981
Phone (772) 335-0888

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1851398994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-466-8884",
            "fax_number": "772-466-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-466-8884",
            "fax_number": "772-466-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNGER",
        "first_name": "DENISE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME68275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378728100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.