Kathryn Kuscavage, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108160 Issued in FL

Practice address

106 Park Place Blvd Ste C
Davenport, FL 33837-6868

Phone

(863) 588-4775

Fax

(863) 422-7664

NPI assigned

Dec 13, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kathryn.kuscavage.1@6807.direct.athenahealth.com

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

• Soni Family Practice, PLLC

  • Family Medicine Physician
  • Davenport, FL
  • NPI 1083957583
  Medicare reassignment
• SFP PC Holdings, Inc.

  • Multi-Specialty Clinic/Center
  • Davenport, FL
  • NPI 1225923667
  NPD
• Soni Family Practice, PLLC

  • Family Medicine Physician
  • Poinciana, FL
  • NPI 1912723750
  NPD (past)

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

{
    "created_epoch": "1418428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1033517669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7824 LAKE UNDERHILL RD STE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228201",
            "telephone_number": "689-223-3898",
            "fax_number": "689-223-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PARK PLACE BLVD STE C",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376868",
            "telephone_number": "863-588-4775",
            "fax_number": "863-422-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSCAVAGE",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-13",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108160",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bala Kode, PHARMD
• Srinath Reddy Kosanam, M.D
• David Krawczyk, PT, DPT
• Nicole Krueger
• Amanda Marie Kummer
• Samuel Labib
• Rocio Labrada, MSN, APRN, FNP-BC
• Rotchilaw Laguerre
• Lake Mary Spine & Rehabilitation Center (Davenport Spine and Rehab Center)
• Shruthi Lakshmana, BDS,DMD,MS

• Physician Assistant in Davenport, FL
• Providers in Davenport, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.