Tayla Mae Kavanaugh, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9106206 Issued in FL

Practice address

601 Main St
Dunedin, FL 34698-5848

Phone

(727) 733-1111

NPI assigned

Oct 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Coastline Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dunedin, FL
  • NPI 1891744769
  Medicare reassignment NPD
• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467
  Medicare reassignment
• Tenet Florida Physician Services, LLC

  • Physical Therapist
  • West Palm Beach, FL
  • NPI 1699111211
  NPD
• Prohealth Select, Inc.

  • Nurse Practitioner
  • Boca Raton, FL
  • NPI 1417485053

  Surgical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1013292424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 3RD AVE S",
            "address_2": "APARTMENT #137",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014144",
            "telephone_number": "716-338-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MAIN ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346985848",
            "telephone_number": "727-733-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "TAYLA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Karl
• Sharon Karn
• Deborah Berckes Kasprzyk
• Elissa Kast, L.M.T.
• Kathleen P Soe DO Dermatology PA
• Lawrence Edward Kay, M.D.
• Shelby Griffin Kehoe, PHARMD, RPH
• Shauna Kelley, COTA/L
• Christopher P Kelly, PA
• Lisa King Kendall, FNP

• Surgical Physician Assistant in Dunedin, FL
• Providers in Dunedin, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.