Individual provider Active NPI

Andrew Stuart Kinney, PA-C

  • Medical Physician Assistant
  • Largo, FL
National Provider Identifier
1104108240
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106088 Issued in FL
Practice address
13670 Walsingham Rd
Largo, FL 33774-3532
Phone
(727) 593-9848
Fax
(727) 596-4532
NPI assigned
Sep 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106088 FL Primary

Addresses

Primary practice location

13670 Walsingham Rd
Largo, FL 33774-3532

Mailing address

6827 1St Ave S
Suite 200
St Petersburg, FL 33707-1242
Phone (727) 767-0575

Other identifiers 1

IdentifierTypeStateIssuer
019264600MedicaidFL

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
I20150312000507 FL Practitioner - Physician Assistant 0547408288 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106088FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Dec 20, 2020 Accepting new patients
Baycare Urgent Care, LLC CurrentSince Jan 9, 2017 Accepting new patients
Baycare Medical Group Pediatric Walk-in Care LLC Past Accepting new patients
Baycare Medical Group Pediatric Walk-in, LLC Past Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Fl 3
Clearwater, FL 33759

13670 Walsingham Rd
Largo, FL 33774
Phone (727) 593-9848

4211 Van Dyke Rd
Ste 200
Lutz, FL 33558
Phone (813) 264-6490

4821 US Highway 19
Ste 5
New Port Richey, FL 34652
Phone (727) 851-9650

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

10141 Big Bend Rd
Ste 206
Riverview, FL 33578
Phone (813) 321-6580

2331 4th St N
St Petersburg, FL 33704
Phone (727) 593-9848

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: andrew.kinneypa-c@direct.mybaycare.org

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": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1104108240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6827 1ST AVE S",
            "address_2": "SUITE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071242",
            "telephone_number": "727-767-0575",
            "fax_number": "727-333-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13670 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-593-9848",
            "fax_number": "727-596-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "ANDREW",
        "middle_name": "STUART",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-14",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019264600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.