Individual provider Active NPI

Dorothy Lasky, PA

  • Physician Assistant
  • The Villages, FL
National Provider Identifier
1366551269
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101063 Issued in FL
Practice address
2910 Brownwood Blvd
The Villages, FL 32163
Phone
(352) 674-8700
Fax
(352) 674-8714
NPI assigned
Aug 30, 2006
Last updated
Oct 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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 PA9101063 FL Primary

Addresses

Primary practice location

2910 Brownwood Blvd
The Villages, FL 32163

Mailing address

1020 Lake Sumter LNDG
The Villages, FL 32162-2699
Phone (352) 674-8905

Other practice location 1

1507 Buenos Aires Blvd
Lady Lake, FL 32159-8974
Phone (352) 350-1600

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
I20050917000248 FL Practitioner - Physician Assistant 2769415959 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Multi Care LLCGroup PAC ID 8729311204, 4 clinicians
Mobile Visiting Practitioners, LLCGroup PAC ID 7810239100, 25 clinicians

Practice addresses (Care Compare)

11521 W Emerald Oaks Dr
Crystal River, FL 34428-2815

140 S Beach St
Suite 202
Daytona Beach, FL 32114-4409
Phone (888) 506-8836

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9101063FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Dermatology and Skin Surgery Inc Past Accepting new patients
Access Healthcare LLC Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1366551269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LAKE SUMTER LNDG",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321622699",
            "telephone_number": "352-674-8905",
            "fax_number": "352-674-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BROWNWOOD BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32163",
            "telephone_number": "352-674-8700",
            "fax_number": "352-674-8714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 Buenos Aires Blvd",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321598974",
            "country_code": "US",
            "telephone_number": "352-350-1600",
            "fax_number": "352-750-8032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASKY",
        "first_name": "DOROTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.