Individual provider Active NPI

Ocynth Shelly Ann Hansel, PA-C

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1285034538
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108092 Issued in FL
Practice address
1755 N Florida Ave
Lakeland, FL 33805-3109
Phone
(863) 904-6200
Fax
(352) 448-0153
NPI assigned
Aug 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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 PA9108092 FL Primary

Addresses

Primary practice location

1755 N Florida Ave
Lakeland, FL 33805-3109

Mailing address

PO Box 95004
Lakeland, FL 33804-5004
Phone (863) 680-7206

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
I20141229002153 FL Practitioner - Physician Assistant 7214250190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 Suwannee Ave NW
Branford, FL 32008-3265
Phone (352) 738-7546

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9108092FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Comprehensive Dermatology CurrentSince Dec 30, 2025 Accepting new patients

Locations

208 Suwannee Ave NW
Branford, FL 32008
Phone (352) 738-7546

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1285034538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95004",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338045004",
            "telephone_number": "863-680-7206",
            "fax_number": "352-448-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053109",
            "telephone_number": "863-904-6200",
            "fax_number": "352-448-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEL",
        "first_name": "OCYNTH",
        "middle_name": "SHELLY ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-23",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.