Alicia Londergan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAT9107472 Issued in FL

Practice address

611 Main St.
Dunedin, FL 34698-6764

Phone

(727) 733-1111

NPI assigned

Sep 19, 2013

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

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

State licenses

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.

• Coastline Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dunedin, FL
  • NPI 1891744769
  Medicare reassignment

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1427484609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 STARBOARD WAY",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MAIN ST.",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986764",
            "telephone_number": "727-733-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDERGAN",
        "first_name": "ALICIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9107472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifewell Chiropractic LLC
• Linda P Wexler
• Marielle Liniewski
• David Lipps, LMT
• Little Steps Florida LLC
• Susana Londono, DPM, MBA
• Alexandra Lopez-Fulghum, M.S. CCC-SLP
• Norma Lopez-Molina, MD
• Maria Loulourgas, O.D.
• Benjamin Edward Love, P.A

• Physician Assistant in Dunedin, FL
• Providers in Dunedin, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.