Active NPI
Kiarra Pena Corless, MMS, PA-C
- Medical Physician Assistant
- Largo, FL
National Provider Identifier
1164154381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9116148
- Practice address
- 12416 66TH St Ste a
Largo, FL 33773-3430 - Phone
- (727) 547-4700
- NPI assigned
- Jun 27, 2022
- Last updated
- May 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9116148 | FL | Primary |
Addresses
Primary practice location
12416 66TH St Ste a
Largo, FL 33773-3430
Mailing address
12416 66TH St Ste a
Largo, FL 33773-3430
Phone (727) 547-4700
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Wake Forest University School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12416 66TH St
Suite a
Largo, FL 33773-3430
Phone (727) 547-4700
12416 66TH St N
Suite a
Largo, FL 33773-3430
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9116148 | FL | MD | Medical Physician Assistant |
Organizations & group practices 1
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.
-
dba Alexander Orthopaedic Associates
- Orthopaedic Surgery Physician
- Largo, FL
- NPI 1265453286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1164154381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12416 66TH ST STE A",
"city": "LARGO",
"state": "FL",
"postal_code": "337733430",
"telephone_number": "727-547-4700",
"fax_number": "727-394-8661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12416 66TH ST STE A",
"city": "LARGO",
"state": "FL",
"postal_code": "337733430",
"telephone_number": "727-547-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORLESS",
"first_name": "KIARRA",
"middle_name": "PENA",
"credential": "MMS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9116148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.