Individual provider Active NPI

Anna Dubrovich Shuster, DO

  • Family Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1982829628
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS10810 Issued in FL
Practice address
1255 Viscaya Pkwy Ste 200
Cape Coral, FL 33990-3290
Phone
(239) 574-1988
Fax
(239) 574-1435
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101015926 MI
Family Medicine Physician 207Q00000X OS10810 FL Primary

Addresses

Primary practice location

1255 Viscaya Pkwy Ste 200
Cape Coral, FL 33990-3290

Mailing address

12730 New Brittany Blvd Ste 602
Fort Myers, FL 33907-4690
Phone (239) 275-5522

Other identifiers 2

IdentifierTypeStateIssuer
001689100MedicaidFL
146WCOtherFLBCBS OF FLORIDA

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
I20100208000729 FL Practitioner - Family Practice 4880784552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Primary Care of Southwest Florida PLGroup PAC ID 2769389675, 40 clinicians

Practice addresses (Care Compare)

1255 Viscaya Pkwy
Suite 200
Cape Coral, FL 33990-3290
Phone (239) 574-1988

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
  • Pinnacle Home Care Home health agency, Fort Myers, FL, CCN 683113
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS10810FLMDFamily Medicine Physician
5101015926MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Primary Care of Southwest Florida PL Family Medicine CurrentSince Feb 1, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1304 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 574-1988

1265 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 573-7337

1255 Viscaya Pkwy
Ste 200
Cape Coral, FL 33990
Phone (239) 574-1988

1255 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 573-7337

12730 New Brittany Blvd
Ste 602
Fort Myers, FL 33907
Phone (239) 275-5522

12730 New Brittany Blvd
Ste 200
Fort Myers, FL 33907
Phone (239) 275-5857

Organizations & group practices 2

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

Hospital & facility affiliations 5

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1982829628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 NEW BRITTANY BLVD STE 602",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074690",
            "telephone_number": "239-275-5522",
            "fax_number": "239-275-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 VISCAYA PKWY STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903290",
            "telephone_number": "239-574-1988",
            "fax_number": "239-574-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTER",
        "first_name": "ANNA",
        "middle_name": "DUBROVICH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015926",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001689100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "146WC",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.