Individual provider Active NPI

Kathlyn Lorge, PA-C

  • Physician Assistant
  • Mount Dora, FL
National Provider Identifier
1013796002
Registry record updated Jan 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117889 Issued in FL
Practice address
19015 US Highway 441
Mount Dora, FL 32757-6708
Phone
(352) 383-3484
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117889 FL Primary

Addresses

Primary practice location

19015 US Highway 441
Mount Dora, FL 32757-6708

Mailing address

19015 US Highway 441
Mount Dora, FL 32757-6708
Phone (352) 383-3484

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231203000053 FL Practitioner - Physician Assistant 0244688190 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Sunbelt, Inc.Group PAC ID 6406849256, 212 clinicians

Practice addresses (Care Compare)

12500 S Apopka Vineland Rd
Orlando, FL 32836-6723
Phone (407) 934-2273

440 W Hwy 436
Adventhealth Centra Care Altamonte
Altamonte Springs, FL 32714-4136
Phone (407) 788-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9117889FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Dec 21, 2023 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Dec 21, 2023 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

19015 US Highway 441
Mount Dora, FL 32757
Phone (352) 383-3484

Interoperability endpoints

  • Direct secure messaging: klorge803052@adventhealth.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1013796002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19015 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576708",
            "telephone_number": "352-383-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19015 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576708",
            "telephone_number": "352-383-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORGE",
        "first_name": "KATHLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.