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Dr. Susan R. King , PsyD

Psychologist β€’ Estero, FL

Active NPI 1013093624 Individual Practitioner Female Practitioner
Practice location in NPPES

3501 Health Center Blvd
Estero, FL 341358127

Call 2394680300 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3501 Health Center Blvd

Estero, FL 341358127

Telephone 2394680300
Fax 2393434257
Organization at the Same NPPES Address or Phone
Bonita Community Health Center Inc Facility NPI 1760459762

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Fort Myers, FL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. King has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. King as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Estero and Florida

6 active clinicians are listed under Psychologist with a practice address in Estero, FL (2,204 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-10-26
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES FL PY6846

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

License # reported to NPPES FL PY6846

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
102285100 (FL)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CLINICAL PSYCHOLOGIST

Medicare Enrollment ID

I20040611000315

Enrollment State Jurisdiction

FL

PECOS Control ID

4587647318

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

15901 Bass Rd Ste 108

Fort Myers, FL 339083838

Phone: 2393436050

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
NPI 1497922298

Doctor of Medicine (M.D.)

Dr. Alan Goldstein , MD

Emergency Medicine

NPI 1467440438

Doctor of Medicine (M.D.)

Pedro Ramos , PA

Physician Assistant

NPI 1184055121

Physician Assistant

Christopher Rosebrough , PT

Physical Medicine & Rehabilitation

NPI 1831654599

Physical Therapist

Dr. Brian Wilson , MD

Family Medicine

NPI 1124059803

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ“
Updated Practice Location October 26, 2022

Registered at 3501 HEALTH CENTER BLVD, ESTERO, FL 341358127 (Tel: 2394680300)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2022

Psychologist (license number reported to NPPES: FL PY6846)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2021

Psychologist (license number reported to NPPES: FL PY6846)

πŸ“
Updated Practice Location April 17, 2019

Registered at 15901 BASS RD STE 108, FORT MYERS, FL 339083838 (Tel: 2393436050)

πŸ“
Updated Business Mailing Address April 17, 2019

Registered at PO BOX 2147, FORT MYERS, FL 339022147 (Tel: 2393436050)

βœ…
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 08, 2007

Registered at 5245 RAMSEY WAY, SUITE ONE, FORT MYERS, FL 339072124 (Tel: 2399390274)

πŸ“
Business Mailing Address (Initial Record) July 08, 2007

Registered at 5245 RAMSEY WAY, SUITE ONE, FORT MYERS, FL 339072124 (Tel: 2399390274)

πŸ‘€
Provider Name / Credentials (Initial Record) July 08, 2007

Recorded as SUSAN KING, PSY.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (license number reported to NPPES: FL PY6846)

🟒
Initial NPI Registration & Enumeration October 27, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1013093624
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2006
Last Update: October 26, 2022
Sole Proprietor: No

Mailing Address

Po Box 2147

Fort Myers, FL 339022147

Phone: 2393436050

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.