Individual provider Active NPI

Catherine Lebeau, PA-C

  • Physician Assistant
  • Englewood, FL
National Provider Identifier
1033973946
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118377 Issued in FL
Practice address
699 S Indiana Ave
Englewood, FL 34223-3705
Phone
(941) 477-4007
Fax
(877) 239-7174
NPI assigned
Feb 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 9118377 FL Primary

Addresses

Primary practice location

699 S Indiana Ave
Englewood, FL 34223-3705

Mailing address

329 15TH Ave SW
Largo, FL 33770-7505
Phone (208) 360-4274

Other practice location 1

1530 4th St N
St Petersburg, FL 33704-4412
Phone (727) 821-8700

Other practice location 2

315 Nokomis Ave S
Venice, FL 34285-2417
Phone (941) 477-4007

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
I20240321003325 FL Practitioner - Physician Assistant 5597102863 Reassigns benefits to 2 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
Bliss Dermatology LLCGroup PAC ID 9335594316, 5 clinicians

Practice addresses (Care Compare)

315 Nokomis Ave S
Venice, FL 34285-2417
Phone (941) 477-4007

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9118377FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantis Clinic PA CurrentSince Mar 1, 2024 Accepting new patients
Atlantis Clinic PA CurrentSince Mar 1, 2024 Accepting new patients

Locations

3705 Tampa Rd
Ste 22
Oldsmar, FL 34677
Phone (813) 891-6343

1530 4th St N
St Petersburg, FL 33704
Phone (727) 821-8700

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1033973946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 15TH AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337707505",
            "telephone_number": "208-360-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 S INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233705",
            "telephone_number": "941-477-4007",
            "fax_number": "877-239-7174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 4th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337044412",
            "country_code": "US",
            "telephone_number": "727-821-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 Nokomis Ave S",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342852417",
            "country_code": "US",
            "telephone_number": "941-477-4007",
            "fax_number": "877-239-7174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBEAU",
        "first_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

Verify at the official NPI Registry.