Individual provider Active NPI

Sara Dube, P.A.

  • Medical Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1962434803
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102993 Issued in FL
Practice address
1550 Barkley Cir
Fort Myers, FL 33907-4539
Phone
(239) 938-2000
Fax
(239) 278-0404
NPI assigned
Jul 7, 2006
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102993 FL Primary

Addresses

Primary practice location

1550 Barkley Cir
Fort Myers, FL 33907-4539

Mailing address

1550 Barkley Cir
Fort Myers, FL 33907-4539
Phone (239) 938-2000

Other practice location 1

1002 Country Club Blvd
Cape Coral, FL 33990-3025
Phone (239) 938-2000

Other identifiers 5

IdentifierTypeStateIssuer
105860000MedicaidFL
12716840OtherCAQH
1883836OtherCIGNA
Y06MTOtherBCBS
Q34871OtherUPIN

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
I20050207000492 FL Practitioner - Physician Assistant 6103877220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Heart Associates PLGroup PAC ID 2769460211, 27 clinicians

Practice addresses (Care Compare)

1550 Barkley Cir
Fort Myers, FL 33907-4539
Phone (239) 938-2000

Hospital & facility affiliations

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1962434803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074539",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074539",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 Country Club Blvd",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339903025",
            "country_code": "US",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBE",
        "first_name": "SARA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105860000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12716840",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1883836",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y06MT",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Q34871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.