Individual provider Active NPI

Amy Jenelle Lash, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1548640196
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9108741 Issued in FL
Practice address
1714 Mahan Center Blvd
Tallahassee, FL 32308-5427
Phone
(850) 205-6232
Fax
(850) 402-9130
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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 PAT9108741 FL Primary

Addresses

Primary practice location

1714 Mahan Center Blvd
Tallahassee, FL 32308-5427

Mailing address

PO Box 13859
Tallahassee, FL 32317-3859
Phone (850) 877-4134

Other practice location 1

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 792-2649

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
I20160311002084 FL Practitioner - Physician Assistant 6901102276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1707 Riggins Rd
Tallahassee, FL 32308-5317
Phone (850) 877-4134

Merit-based Incentive Payment System (MIPS)

Final score
89.59 of 100Reported as group
Quality
100
Promoting interoperability
91
Improvement activities
40
Cost
72.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9108741FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Tallahassee, PA CurrentSince Feb 1, 2016 Accepting new patients

Locations

19611 State Road 20 W
Blountstown, FL 32424
Phone (850) 674-5645

110 NE 5th St
Carrabelle, FL 32322
Phone (850) 697-1118

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1707 Riggins Rd
Tallahassee, FL 32308
Phone (850) 205-6232

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1548640196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13859",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173859",
            "telephone_number": "850-877-4134",
            "fax_number": "850-402-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 MAHAN CENTER BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085427",
            "telephone_number": "850-205-6232",
            "fax_number": "850-402-9130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Miccosukee Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085054",
            "country_code": "US",
            "telephone_number": "850-792-2649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASH",
        "first_name": "AMY",
        "middle_name": "JENELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9108741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.