Lauren Michelle Kissock, PA-S

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9122313 Issued in FL

Practice address

9981 S Healthpark Dr Ste 156
Fort Myers, FL 33908-3618

Phone

(239) 343-6341

Fax

(239) 343-4242

NPI assigned

Feb 19, 2020

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Pacific Medical College, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiothoracic and Vascular Surgeons,PAGroup PAC ID 3870577729, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St David's Medical Center Hospital, Austin, TX, CCN 450431
• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718

Merit-based Incentive Payment System (MIPS)

Final score

86.06 of 100Reported as group

Quality

67.35

Promoting interoperability

97

Improvement activities

40

Cost

72.02

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: lauren.kissock.1@856.direct.athenahealth.com

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.

• Cardiothoracic and Vascular Surgeons,PA

  dba VeinSolutions

  • Surgery Physician
  • Austin, TX
  • NPI 1326061714
  Medicare reassignment Care Compare group

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

• St Davids Healthcare Partnership LP LLP

  dba Round Rock Medical Center

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  dba Heart Hospital of Austin

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1558994459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 40TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564010",
            "telephone_number": "512-459-8753",
            "fax_number": "512-483-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 S HEALTHPARK DR STE 156",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083618",
            "telephone_number": "239-343-6341",
            "fax_number": "239-343-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 W 40th St",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787564010",
            "country_code": "US",
            "telephone_number": "512-459-8753",
            "fax_number": "512-483-6807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSOCK",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9122313",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14137",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA14137",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9122313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132906200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4192098",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; 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.