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PEACH SUPUPRAMAI DO
NPI 1235766296
Student in an Organized Health Care Education/Training Program in Fort Lauderdale, FL

Active since March 26, 2020PECOS EnrolledAccepts Medicare Assignment
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316(954) 355-4400 Get Directions Write a Review

NPPES record last updated: March 26, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Peach Supupramai Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEACH SUPUPRAMAI DO (NPI 1235766296) is an individual student in an organized health care education/training program in Fort Lauderdale, Florida and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Holy Cross Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1235766296
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NamePEACH SUPUPRAMAICredential: DO
Location Address1600 S ANDREWS AVEFort Lauderdale, FL 33316-2510
Mailing Address1600 S Andrews AveFort Lauderdale, FL 33316-2510
Phone(954) 355-4400
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 26, 2020
NPPES CertifiedMarch 26, 2020
✔ NPI 1235766296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1600 S ANDREWS AVE, Fort Lauderdale, FL 33316
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Peach Supupramai Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163877093
PECOS Enrollment IDI20231012003871
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
171 services110 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
112 services89 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
88 services88 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
35 services35 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Holy Cross Hospital

Acute Care Hospitals · Fort Lauderdale, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100073
Location4725 N Federal HwyFort Lauderdale, FL 33308 · Broward County
Emergency services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANNE MATTOX PARKER M.D.
Pediatrics
1600 S ANDREWS AVE, NEWBORN NURSERY
FORT LAUDERDALE, FL 33316
Broward County (954) 355-5810
AKILAH FULLER PHARMD, MS
Pharmacist
1600 S ANDREWS AVE
FORT LAUDERDALE, FL 33316
Broward County (954) 355-4400
JACOB GOLDENBERG MD
Student in an Organized Health Care Education/Training Program
1600 S ANDREWS AVE
FORT LAUDERDALE, FL 33316
Broward County (954) 941-8300
TIFFANY SKYE SCULTHORPE DO, MS
Student in an Organized Health Care Education/Training Program
1600 S ANDREWS AVE
FORT LAUDERDALE, FL 33316
Broward County (954) 355-4400
JOHN BERNE MD
Surgery
1600 S ANDREWS AVE
FORT LAUDERDALE, FL 33316
Broward County (305) 918-7050
DR. EDUARDO A. OTERO M.D.
Pediatrics (Neonatal-Perinatal Medicine)
1600 S ANDREWS AVE, 4TH FLR NICU
FT LAUDERDALE, FL 33316
Broward County (954) 355-5870
WESTSIDE HOSPITALIST INC
Hospitalist
1600 S ANDREWS AVE
FORT LAUDERDALE, FL 33316
Broward County (954) 355-4400
PETER A. NAMNUM, MD, PA
Internal Medicine (Pulmonary Disease)
1600 S ANDREWS AVE
FORT LAUDERDALE, FL 33316
Broward County (954) 355-4400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peach Supupramai's NPI number?

The NPI number for Peach Supupramai is 1235766296. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Peach Supupramai located?

Peach Supupramai practices at 1600 S Andrews Ave, Fort Lauderdale, FL 33316. The listed phone number is (954) 355-4400.

What is Peach Supupramai's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Peach Supupramai enrolled in Medicare?

Yes. Peach Supupramai is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Peach Supupramai accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Peach Supupramai as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Peach Supupramai affiliated with any hospitals?

According to CMS data, Peach Supupramai is affiliated with Holy Cross Hospital.

When was this NPI record last updated?

The NPPES record for Peach Supupramai was last updated on March 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.