Michelle A Pettit, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004438 Issued in VA

Practice address

4215 Edgewater Dr
Orlando, FL 32804-2206

Phone

(973) 826-8291

NPI assigned

Oct 20, 2006

Last updated

Mar 12, 2021By the provider in NPPES

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
  • NPI 1497748743
  Medicare reassignment Care Compare group
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Temple Terrace, FL
  • NPI 1386639920
  Medicare reassignment
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Tampa, FL
  • NPI 1164179156
  NPD
• Musculoskeletal Institute Chartered

  • Orthopaedic Surgery Physician
  • Zephyrhills, FL
  • NPI 1467305839
  NPD
• Southeastern Clinical Services,Inc.

  • Surgical Physician Assistant
  • Orlando, FL
  • NPI 1033162011
  NPD
• Lakeland Regional Health Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lakeland, FL
  • NPI 1588427991
  NPD (past)
• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  NPD (past)

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

• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1114000676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4059",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074744059",
            "telephone_number": "973-826-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 EDGEWATER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328042206",
            "telephone_number": "973-826-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhana Petkova Petrova-Sabevska, SLP
• Hannah G Petrunak
• Linda Dianne Petticrew, M.ED. CCC-A
• Gwen L Pettit
• Kathleen D. Pettit, RN
• Arthur Montgomery Petty III, M.D.
• Jhade Peynado
• Glenn A Pfaff, MD
• Nancy Pfaff, RN
• Anna Pfalz

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.