Individual provider Active NPI

Alissa Lauren Kitchen

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1396215141
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2010 59TH St W Ste 4200
Bradenton, FL 34209-4687
Phone
(941) 794-3999
NPI assigned
Dec 4, 2018
Last updated
Dec 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 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 NU Primary

Addresses

Primary practice location

2010 59TH St W Ste 4200
Bradenton, FL 34209-4687

Mailing address

10965 Clarendon St
Fort Myers, FL 33913-8562
Phone (573) 673-2754

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
I20200818000744 FL Practitioner - Physician Assistant 2062838360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Cardiology Network, LLCGroup PAC ID 8729260641, 83 clinicians

Practice addresses (Care Compare)

2010 59TH St W
Suite 4200
Bradenton, FL 34209-4687
Phone (941) 794-3999

6006 49TH St N
Saint Petersburg, FL 33709-2149

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Quality
73.64
Promoting interoperability
99
Improvement activities
40
Cost
68.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Consultants Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: alissa.kitchen@hca4.eclinicaldirectplus.com

Organizations & group practices 2

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": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1396215141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10965 CLARENDON ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138562",
            "telephone_number": "573-673-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 59TH ST W STE 4200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094687",
            "telephone_number": "941-794-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHEN",
        "first_name": "ALISSA",
        "middle_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.