David B Sudderth, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME55197 Issued in FL

Practice address

3210 Cleveland Ave
Suite 100
Fort Myers, FL 33901-7182

Phone

(239) 936-6778

Fax

(239) 210-0225

NPI assigned

Jul 21, 2005

Last updated

Jun 18, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Neurology

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kagan Jugan and Associates PAGroup PAC ID 5799676193, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kagan Jugan & Associates PA

  • Orthopaedic Surgery Physician
  • Fort Myers, FL
  • NPI 1861450827
  Medicare reassignment Care Compare group NPD
• Kagan, Jugan & Associates

  • Orthopaedic Surgery Physician
  • Lehigh Acres, FL
  • NPI 1912232299
  NPD
• Charlotte Resources Inc

  dba The MRI Center of Charlotte County

  • Diagnostic Radiology Physician
  • Port Charlotte, FL
  • NPI 1659364743
  NPD (past)
• Neuroscience and Spine Associates PL

  • Interventional Pain Medicine Physician
  • Naples, FL
  • NPI 1669536645
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1902805856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 CLEVELAND AVE",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017182",
            "telephone_number": "239-936-6778",
            "fax_number": "239-210-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 CLEVELAND AVE",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017182",
            "telephone_number": "239-936-6778",
            "fax_number": "239-210-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDERTH",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME55197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1902805856",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08754",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daren Dianan Subnaik, D.O.
• Patricia Carolina Subnaik, D.O.
• Successful Steps Support Care LLC
• Natalya Suchodolski, MD
• Wendy Sue Suckow, PA-C
• Aiste Sudmantaite
• Avinash Rai Sukhram, M.D
• Allison Sullivan, M.A., M.F.T.
• Clarissa Sullivan
• John Patrick Sullivan, M.D.

• Neurology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.