Individual provider Active NPI

Kyle Alan Hopkins, PA

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1407618705
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118389 Issued in FL
Practice address
52 W Underwood St
MP 153
Orlando, FL 32806
Phone
(352) 841-2558
Fax
(407) 849-6470
NPI assigned
Jan 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X PA9118389 FL
Physician Assistant 363A00000X PA9118389 FL Primary

Addresses

Primary practice location

52 W Underwood St
MP 153
Orlando, FL 32806

Mailing address

52 W Underwood St
MP 153
Orlando, FL 32806
Phone (352) 841-2558

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
I20240220000069 FL Practitioner - Physician Assistant 0941644843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

801 E Dixie Ave
Suite 104
Leesburg, FL 34748-7601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9118389FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Medical Imaging and Breast Center at the Villages LLC CurrentSince Feb 18, 2024 Accepting new patients
Lake Medical Imaging and Breast Center at the Villages LLC PastSince Jul 25, 2021 Accepting new patients

Locations

734 N 3rd St
Ste 115
Leesburg, FL 34748
Phone (352) 365-2583

910 Old Camp Rd
Ste 120
The Villages, FL 32162

Organizations & group practices 4

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1407618705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W UNDERWOOD ST",
            "address_2": "MP 153",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "352-841-2558",
            "fax_number": "407-849-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W UNDERWOOD ST",
            "address_2": "MP 153",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "352-841-2558",
            "fax_number": "407-849-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKINS",
        "first_name": "KYLE",
        "middle_name": "ALAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "PA9118389",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.