Kaitlyn Roeder, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9121071 Issued in FL

Practice address

414 W Robertson St
Brandon, FL 33511-5007

Phone

(813) 701-5804

Fax

(813) 291-7615

NPI assigned

Jun 3, 2024

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Excel Pain and Spine LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun City Center, FL
  • NPI 1063028587
  Medicare reassignment NPD
• Excel Pain and Spine LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sarasota, FL
  • NPI 1023811619
  NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1083455182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225201",
            "telephone_number": "727-823-2188",
            "fax_number": "727-828-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W ROBERTSON ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115007",
            "telephone_number": "813-701-5804",
            "fax_number": "813-291-7615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2310 North Blvd W Ste A",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338378988",
            "country_code": "US",
            "telephone_number": "813-701-5804",
            "fax_number": "813-291-7615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7032 US Highway 301 N",
            "address_purpose": "LOCATION",
            "city": "Ellenton",
            "state": "FL",
            "postal_code": "342223030",
            "country_code": "US",
            "telephone_number": "813-701-5804",
            "fax_number": "813-291-7615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 Harden Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338031826",
            "country_code": "US",
            "telephone_number": "813-701-5804",
            "fax_number": "813-291-7615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28050 US Highway 19 N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612600",
            "country_code": "US",
            "telephone_number": "813-701-5804",
            "fax_number": "813-291-7615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "KAITLYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Rodriguez, APRN
• Sara Catalina Rodriguez
• Vanessa Rodriguez, CRC, ICVE, CVE, CDMS
• Angel Adella Roe, ARNP CPNP-PC
• Gail Williams Roe
• Beverly Yeshion Roetter, ARNP
• Megan E Rog, PAC
• Sharee Rogers-Sampson, NP
• Jeremy B Rogers, MD
• Truly Rogers

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.