Individual provider Active NPI

Kaycee Lauren Villane, PA-C

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1225686835
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115827 Issued in FL
Practice address
5153 N 9TH Ave Ste 302
Pensacola, FL 32504-5719
Phone
(850) 416-2250
Fax
(850) 416-2536
NPI assigned
Aug 27, 2019
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115827 FL Primary

Addresses

Primary practice location

5153 N 9TH Ave Ste 302
Pensacola, FL 32504-5719

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

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
I20220427000114 FL Practitioner - Physician Assistant 0244667616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

36500 Emerald Coast Pkwy
Destin, FL 32541-4713
Phone (850) 416-1575

5151 N 9TH Ave
Suite 200
Pensacola, FL 32504-8721
Phone (850) 416-4188

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3369SCMDPharmacist
PA9115827FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Sacred Heart Health System Inc CurrentSince Apr 1, 2022 Accepting new patients
Grand Strand Surgical Specialists, LLC PastSince Feb 1, 2020 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

5147 N 9th Ave
Ste 103
Pensacola, FL 32504
Phone (850) 416-1900

5153 N 9th Ave
Ste 302
Pensacola, FL 32504
Phone (850) 416-2250

Interoperability endpoints

  • Direct secure messaging: kaycee.villane.1@9582.direct.athenahealth.com

Organizations & group practices 4

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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1225686835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 N 9TH AVE STE 302",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045719",
            "telephone_number": "850-416-2250",
            "fax_number": "850-416-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANE",
        "first_name": "KAYCEE",
        "middle_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.