Heather Lacy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA112700 Issued in FL

Practice address

6310 Health Park Way Ste 200
Lakewood Ranch, FL 34202-5177

Phone

(941) 907-4737

Fax

(941) 907-9493

NPI assigned

Nov 22, 2019

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alliance Telehealth Network LLCGroup PAC ID 2466988308, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alliance Telehealth Network LLC

  • Multi-Specialty Clinic/Center
  • Pensacola, FL
  • NPI 1477309789
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1235775453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 HEALTH PARK WAY STE 200",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025177",
            "telephone_number": "941-907-4737",
            "fax_number": "941-907-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "HEATHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA112700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynne Labron, APRN
• Michael A Labun Sr.
• Kimberly Lacivita, PSY.D. P.A.
• Gillian Anna Laco, DPT
• Peter Lacroce, PHARM.D.
• Emmy Caroline Ladehoff
• Jeffrey Shane Ladwig, APRN
• Juergen Lafrenz, D.D.S.
• Lakewood Ranch Anesthesia PL
• Lakewood Ranch Enterprises LLC

• Physician Assistant in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.