Individual provider Active NPI

Ilysa Karin Howarth, PA

  • Physician Assistant
  • Lakewood Ranch, FL
National Provider Identifier
1083041115
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108415 Issued in FL
Practice address
14405 Arbor Green TRL
Lakewood Ranch, FL 34202-8409
Phone
(941) 917-7080
Fax
(941) 917-7085
NPI assigned
Oct 3, 2013
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 PA9108415 FL Primary

Addresses

Primary practice location

14405 Arbor Green TRL
Lakewood Ranch, FL 34202-8409

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other practice location 1

8430 Enterprise Cir
Suite 130
Lakewood Ranch, FL 34202-4107
Phone (941) 366-3000

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
I20161024001011 FL Practitioner - Physician Assistant 9739310491 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9108415FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ilysa.howarth@fpg.directbygreenway.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1083041115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14405 ARBOR GREEN TRL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342028409",
            "telephone_number": "941-917-7080",
            "fax_number": "941-917-7085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8430 Enterprise Cir",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342024107",
            "country_code": "US",
            "telephone_number": "941-366-3000",
            "fax_number": "941-366-3002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOWARTH",
        "first_name": "ILYSA",
        "middle_name": "KARIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.