Derrick Antonio Legoas, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107024 Issued in FL

Practice address

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Phone

(813) 745-7365

Fax

(813) 449-8618

NPI assigned

Feb 25, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer SCRN Ctr IncGroup PAC ID 2264337021, 1,145 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc

  dba Moffitt Medical Group

  • Hematology & Oncology Physician
  • Tampa, FL
  • NPI 1306833595
  Medicare reassignment Care Compare group
• Bay Area Emergency Physicians LLC

  • Emergency Medicine Physician
  • Clearwater, FL
  • NPI 1164459095
  Medicare reassignment
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment
• Pasco County Emergency Physicians LLC

  • Emergency Medicine Physician
  • New Port Richey, FL
  • NPI 1568771707
  Medicare reassignment
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790
  NPD
• FL-I Medical Services, PA

  • Nurse Practitioner
  • Okeechobee, FL
  • NPI 1376818500

  Physician Assistant

  NPD
• Baycare Medical Group Pediatric Walk-in Care LLC

  • Pediatrics Physician
  • Lutz, FL
  • NPI 1861850117
  NPD (past)
• Baycare Medical Group Pediatric Walk-in, LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1679724488
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc.

  • Special Hospital
  • Tampa, FL
  • NPI 1780653618
  Care Compare affiliation

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741478400000",
    "number": "1487994661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 Madison St",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346521971",
            "country_code": "US",
            "telephone_number": "727-815-7207",
            "fax_number": "727-266-4951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGOAS",
        "first_name": "DERRICK",
        "middle_name": "ANTONIO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-25",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010785200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Legacy Surgery Center LLC
• Legacy Whole Health, PLLC
• Kaileen M Legard, APRN
• Pierre Leger, MD
• Larry Theodore Legg II, LCSW
• Deyanira Lara Legorburu
• Joel H Legoskey, CRNA
• Vianka Legra Delgado, MD
• Arian Legra Navarro
• Angela Daliana Legra Reyes

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.