Individual provider Active NPI

Steven Kurumada, PA

  • Physician Assistant
  • Fort Pierce, FL
National Provider Identifier
1851867105
Registry record updated Oct 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111728 Issued in FL
Practice address
5101 Okeechobee Rd
Fort Pierce, FL 34947-5415
Phone
(949) 648-6596
NPI assigned
Oct 14, 2018
Last updated
Oct 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9111728 FL Primary

Addresses

Primary practice location

5101 Okeechobee Rd
Fort Pierce, FL 34947-5415

Mailing address

800 Treasure Cay Dr Apt 305
Fort Pierce, FL 34947-5364
Phone (949) 648-6596

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181206002290 FL Practitioner - Physician Assistant 5698019370 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Learning to Achieve Wellness IncGroup PAC ID 9234514464, 48 clinicians

Practice addresses (Care Compare)

1801 SE Hillmoor Dr
Suite C 102
Port St Lucie, FL 34952-7550
Phone (813) 999-1516

413 W Robertson St
Suite B
Brandon, FL 33511-5014
Phone (813) 999-1516

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9111728FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Treatment Centers of America, LLC CurrentSince Jul 2, 2024 Accepting new patients

Locations

1405 SE Goldtree Dr
Ste Ab
Port St Lucie, FL 34952
Phone (855) 700-0327

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, 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": "1539475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539475200000",
    "number": "1851867105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TREASURE CAY DR APT 305",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349475364",
            "telephone_number": "949-648-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 OKEECHOBEE RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349475415",
            "telephone_number": "949-648-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUMADA",
        "first_name": "STEVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-14",
        "last_updated": "2018-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.