Kaela Bacon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9110761 Issued in FL

Practice address

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Phone

(813) 745-7365

Fax

(813) 449-8618

NPI assigned

Jan 18, 2018

Last updated

Aug 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer SCRN Ctr IncGroup PAC ID 2264337021, 1,145 clinicians

FMC Urgent Care LLCGroup PAC ID 7618166984, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• FMC Urgent Care LLC

  dba Florida Medical Clinic Orlando Health Urgent Care

  • Urgent Care Clinic/Center
  • Zephyrhills, FL
  • NPI 1154563120
  Medicare reassignment Care Compare group
• H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc

  dba Moffitt Medical Group

  • Hematology & Oncology Physician
  • Tampa, FL
  • NPI 1306833595
  Medicare reassignment Care Compare group
• Memon Health Associates, LLC

  dba Tampa Urgent Care

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1891164398
  Medicare reassignment

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

• H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc.

  • Special Hospital
  • Tampa, FL
  • NPI 1780653618
  Care Compare affiliation

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1164930616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "KAELA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily G Backes
• Benjamin E Backus, DC
• Jordan Bacon Graveline
• David Bacon Jr.
• John Bacon
• Katherine Bacon
• Nickole Aimee Bacon, APRN-C
• Ahmed Badawy
• Naji Kamal Baddoura, M. D.
• Bader Prosthetics Orthotics

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

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

Verify at the official NPI Registry.