Anisa Lee Mathis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9102039 Issued in FL

Practice address

113 Lielmanis Ave
Hurlburt Field, FL 32544-5613

Phone

(850) 881-5221

Fax

(850) 881-5832

NPI assigned

Aug 1, 2006

Last updated

Jan 9, 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

Other names 1

• Miss Anisa Michelle Lee Former name

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

Practice roles

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.

• Richard W Lucey MD PA

  • Specialist
  • Pensacola, FL
  • NPI 1629253240
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1285640813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-2337",
            "fax_number": "850-881-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-5221",
            "fax_number": "850-881-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "ANISA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANISA",
            "last_name": "LEE",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marc Marrero, IDMT
• Justin R Martin, MD
• Sheridan Ann Martin, O.D.
• Jennifer June Sillence Masino, PSY. D.
• Corrine Lynn Materese, LCSW
• Derick Mayberry, DDS
• Tracy Elizabeth Mayfield, PSYD
• Shardale McAfee
• Velvet L. McAlister, IDMT
• Sandra Lynn McArdle, APRN

• Medical Physician Assistant in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.