Aloysius T Bisong Jr., PA
Individual provider Active NPI Physician Assistant · Lady Lake, FL
NPI 1124294947 · NPPES record last updated Aug 7, 2023
Key facts
- NPI
- 1124294947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9105417 (FL)
- Practice address
- 808 Highway 466
Lady Lake, FL 32159 - Phone
- (352) 751-0040
- Fax
- (352) 751-2825
- NPI assigned
- May 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
319 N Mangoustine Ave
Sanford, FL 32771-1098
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100909000142 | FL | Practitioner - Physician Assistant | 0244355683 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9105417 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Healthcaring Clinic of Florida, LLC | Past | Accepting new patients | |
| Lake Sumter Urology, LLC | Past |
Accepting new patients | |
| Orlando Cancer Center Inc | Past | Accepting new patients | |
| Lakeland Regional Medical Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9105417 | FL | |
| Physician Assistant | 363A00000X | PA9105417 | FL | Yes |
Addresses
Primary practice location
808 Highway 466
Lady Lake, FL 32159
Mailing address
P O Boz 850001 Dept # 8015
Orlando, FL 32885-8015
Phone (352) 861-0440
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9105417 | Other | FL | MEDICAL LICENSE |
Other providers in Lady Lake, FL
- Duane Best
- Better Life Chiropractic and Wellness
- Better Life Medical LLC
- Sarina Bhole
- Bio-Medical Applications of Florida, Inc.
- Christopher L. Bissett
- BJ'S Wholesale Club Inc.
- Blackwell Companion Care
- Bladder Institute of Florida LLC
- Bladder Institute of Florida LLC
All providers in Lady Lake, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.