Individual provider Active NPI

Renato Concepcion, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Estero, FL
National Provider Identifier
1962480715
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME0073459 Issued in FL
Practice address
3501 Health Center Blvd Ste 2410
Estero, FL 34135-8131
Phone
(239) 468-0285
Fax
(239) 468-0288
NPI assigned
Jan 3, 2006
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME0073459 FL Primary

Addresses

Primary practice location

3501 Health Center Blvd Ste 2410
Estero, FL 34135-8131

Mailing address

P.O. Box 2147
Fort Myers, FL 33902-2147
Phone (394) 680-2852

Other practice location 1

8960 Colonial Center Dr
Suite 302
Fort Myers, FL 33905
Phone (239) 343-9686

Other identifiers 6

IdentifierTypeStateIssuer
593551137OtherFLTAX ID
255236100MedicaidFL
237994OtherFLAVMED
43696OtherFLBLUE CROSS/BLUE SHIELD
211104OtherFLAMERIGROUP
5958648OtherFLAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rconcepcion92745@Direct.leememorial.org Lee Memorial Health System

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
I20071017000613 FL Practitioner - EndocrinologyPractitioner - Internal Medicine 9739284449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

3501 Health Ctr Blvd
Suite 2410
Estero, FL 34135-8131
Phone (239) 468-0285

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0073459FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sarroca Medical Center, Inc. CurrentSince Feb 20, 2017 Accepting new patients
Lee Memorial Health System CurrentSince Dec 28, 2015 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Health System Inc Endocrinology, Diabetes & Metabolism CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System Endocrinology, Diabetes & Metabolism CurrentSince Dec 28, 2015 Accepting new patients
South Tampa Medical Group PA Past Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

3501 Health Center Blvd
Ste 2410
Estero, FL 34135
Phone (239) 468-0285

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

8960 Colonial Center Dr
Ste 202
Fort Myers, FL 33905
Phone (239) 343-9646

8960 Colonial Center Dr
Ste 302
Fort Myers, FL 33905
Phone (239) 343-9633

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

3709 W Hamilton Ave
Ste 9
Tampa, FL 33614
Phone (813) 374-7608

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rconcepcion92745@direct.leememorial.org

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, 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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1962480715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "394-680-2852",
            "fax_number": "239-468-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD STE 2410",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341358131",
            "telephone_number": "239-468-0285",
            "fax_number": "239-468-0288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8960 Colonial Center Dr",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "33905",
            "country_code": "US",
            "telephone_number": "239-343-9686",
            "fax_number": "239-343-9687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "RENATO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME0073459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "593551137",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255236100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "237994",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "43696",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "211104",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5958648",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rconcepcion92745@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

Verify at the official NPI Registry.