Patients First Lake Ella Medical Center P a

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PATIENTS FIRST LAKE ELLA MEDICAL CENTER P A

Practice address

1690 N Monroe St
Tallahassee, FL 32303-5533

Phone

(850) 385-2222

Fax

(850) 385-1844

NPI assigned

Sep 2, 2006

Organization subpart

No

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

Authorized official

Name

Andrea Malik Roe

Title

President

Phone

(678) 504-6392

Specialties & licenses 1

Addresses

Other names 1

• Patients First Lake Ella Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 75

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christine Allbaugh, APRN

  • Family Nurse Practitioner
  • Tallahassee, FL
  • NPI 1659051712

  FL

  Medicare reassignment Care Compare group NPD
• Kyle Keith Coston, ARNP

  • Family Nurse Practitioner
  • Tallahassee, FL
  • NPI 1588744247

  FL

  Medicare reassignment Care Compare group NPD
• Jason Forjet, PA

  • Physician Assistant
  • Tallahassee, FL
  • NPI 1164278636

  FL

  Medicare reassignment Care Compare group NPD
• Alia Deyira Green, MD

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1508509092

  Family Medicine, FL

  Medicare reassignment Care Compare group NPD
• Kylie Jordan, APRN

  • Nurse Practitioner
  • Pensacola, FL
  • NPI 1811537855

  FL

  Medicare reassignment Care Compare group NPD
• Emily Karnik, APRN

  • Nurse Practitioner
  • Tallahassee, FL
  • NPI 1871915348

  FL

  Medicare reassignment Care Compare group NPD
• Shiva Lakshmin, MD

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1851379184

  Family Medicine, FL

  Medicare reassignment Care Compare group NPD
• Jennifer Mobley

  • Family Nurse Practitioner
  • Quincy, FL
  • NPI 1396327839

  FL

  Medicare reassignment Care Compare group NPD
• Jessica Kay Oxendine, APRN

  • Nurse Practitioner
  • Tallahassee, FL
  • NPI 1144800491

  FL

  Medicare reassignment Care Compare group NPD
• Dan W.T. Peters, M.D.

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366482994

  Family Medicine, FL

  Medicare reassignment Care Compare group NPD
• Lea Diane Smiroldo, APRN, FNP-C

  • Family Medicine Physician
  • Crawfordville, FL
  • NPI 1699240812

  Family Medicine, FL

  Medicare reassignment Care Compare group NPD
• George Torres, PA-C

  • Physician Assistant
  • Tallahassee, FL
  • NPI 1073383675

  FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1164524039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035533",
            "telephone_number": "850-385-2222",
            "fax_number": "770-626-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035533",
            "telephone_number": "850-385-2222",
            "fax_number": "850-385-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENTS FIRST LAKE ELLA MEDICAL CENTER P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "MALIK ROE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-504-6392"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patients First Lake Ella",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Tallahassee, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.