Individual provider Active NPI

Kailey Quintana, PA-C

  • Physician Assistant
  • Lithia, FL
National Provider Identifier
1346820354
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9114077 Issued in FL
Practice address
13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone
(813) 684-2663
NPI assigned
Apr 13, 2021
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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 9114077 FL Primary

Addresses

Primary practice location

13837 Circa Crossing Dr
Lithia, FL 33547-4382

Mailing address

13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone (813) 684-2663

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
I20210707002136 FL Practitioner - Physician Assistant 0345642815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10740 Palm River Rd
Suite 310
Tampa, FL 33619-4577
Phone (813) 684-2663

1200 7TH Ave N
St. Anthony's Hospital
St Petersburg, FL 33705-1300
Phone (727) 825-1100

13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone (813) 535-6647

2805 54TH Ave N
Suite 100
St Petersburg, FL 33714-2414
Phone (813) 684-2663

4541 S Dale Mabry Hwy
Suite 200
Tampa, FL 33611-1407
Phone (813) 684-2663

6901 Simmons Loop
Riverview, FL 33578-9498
Phone (813) 302-8000

7239 Paradiso Dr
Apollo Beach, FL 33572-1637
Phone (813) 684-2663

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9114077FLMDPhysician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1346820354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "813-684-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "813-684-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "KAILEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9114077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

Verify at the official NPI Registry.