Individual provider Active NPI

Teena Lukose, PA-C

  • Physician Assistant
  • Plant City, FL
National Provider Identifier
1164654968
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2806 James L Redman Pkwy Ste 206
Plant City, FL 33566-9407
Phone
(813) 944-0060
NPI assigned
Aug 13, 2009
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2806 James L Redman Pkwy Ste 206
Plant City, FL 33566-9407

Mailing address

6710 Riverside Bluffs Dr
Riverview, FL 33578-4101

Other practice location 1

6710 Riverside Bluffs Dr
Riverview, FL 33578-4101
Phone (908) 499-3335

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131014000844 FL Practitioner - Physician Assistant 9133353758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2255 Glades Rd
Suite 228W
Boca Raton, FL 33431-8535

701 Sebastian Blvd
Suite D
Sebastian, FL 32958-4379

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Laser Spine Institute, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: teena.lukose.p67@direct.aara1.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1164654968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 RIVERSIDE BLUFFS DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 JAMES L REDMAN PKWY STE 206",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335669407",
            "telephone_number": "813-944-0060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6710 Riverside Bluffs Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335784101",
            "country_code": "US",
            "telephone_number": "908-499-3335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKOSE",
        "first_name": "TEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.