Liesa Clare Erickson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9115833 Issued in FL

Practice address

603 7TH St S
St Petersburg, FL 33701-4719

Phone

(727) 893-6254

Fax

(727) 553-7158

NPI assigned

Oct 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Ohi West Medical Group, LLC

  • Cardiovascular Disease Physician
  • St Petersburg, FL
  • NPI 1518572551
  Medicare reassignment Care Compare group
• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment NPD
• Ohi West Medical Group, LLC

  • Urgent Care Clinic/Center
  • Saint Petersburg, FL
  • NPI 1619583184
  NPD

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

• Ohi West, Inc

  • General Acute Care Hospital
  • St Petersburg, FL
  • NPI 1154399749
  Care Compare affiliation

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1154921047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 7TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014719",
            "telephone_number": "727-893-6254",
            "fax_number": "727-553-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 7TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014719",
            "telephone_number": "727-893-6254",
            "fax_number": "727-553-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "LIESA",
        "middle_name": "CLARE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "STUDENT",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9115833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.baptist-health.com/location/baptist-health-fort-smith/",
            "affiliation": "N",
            "address_1": "1500 Dodson Ave # 285",
            "city": "Fort Smith",
            "state": "AR",
            "country_code": "US",
            "postal_code": "729015182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Equilibrium Massage Inc.
• Natasha Perry Erbiti
• Eric J Roberts DPM PA
• Amy Elsner Erickson, O.T.
• Haley Draughon Erickson, LCSW
• John Ermatinger, LMT
• Austin Erney
• Ernst E. Vieux, Jr., M.D., P.a.
• Jessica Marie Ernsthausen, OTD, OTR/L
• Larry L Ertel, M.D.

• Surgical Physician Assistant in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.