Kelli Lugo, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9107919 Issued in FL

Practice address

7710 S US Highway 1
Port St Lucie, FL 34952-2320

Phone

(772) 446-7209

Fax

(772) 200-2131

NPI assigned

Aug 4, 2006

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kellilugo@cos.directglo.com

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.

• Coastal Orthopaedics & Sports Medicine Center

  dba Coastal Orthopaedic & Sports Medicine Center

  • Specialist
  • Port Saint Lucie, FL
  • NPI 1245291988
  Medicare reassignment NPD
• Mark J Powers MD PA Florida Orthopaedic Specialists

  • Orthopaedic Surgery Physician
  • Port St Lucie, FL
  • NPI 1144284811
  Medicare reassignment
• Mark J Powers MD PA Florida Orthopaedic Specialists

  dba Florida Orthopaedic Specialists

  • Orthopaedic Surgery Physician
  • Stuart, FL
  • NPI 1366947939
  NPD
• Franklin Medical Group, PC

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1780686964
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1245248426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522320",
            "telephone_number": "772-446-7209",
            "fax_number": "772-200-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522320",
            "telephone_number": "772-446-7209",
            "fax_number": "772-200-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "KELLI",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFICATION NUMBER",
            "identifier": "OPA174151",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yanetsi Lozada Borges
• Lsquared Essentials, LLC
• Kevin J Luba, DMD
• Angela June Lucas, FNP-C
• Lucille a Vandevere, LLC (Healthcare Services)
• Roberto Lugo, M.D.
• Thomas Lukat, PHARM D
• Pedro Luna Jr.
• Soila Diana Luna, COTA
• Judith Lunatinill

• Surgical Physician Assistant in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.