Lacey Elissa Rose, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9120077 Issued in FL

Practice address

1700 S Tamiami TRL
Sarasota, FL 34239-3509

Phone

(941) 917-7494

Fax

(941) 917-7739

NPI assigned

Jan 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• SMH Physician Services Inc

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

• Sarasota County Public Hospital District

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1629839709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393509",
            "telephone_number": "941-917-7494",
            "fax_number": "941-917-7739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Main St",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117068408",
            "country_code": "US",
            "telephone_number": "631-968-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "LACEY",
        "middle_name": "ELISSA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "031360",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9120077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosales Chiropractic PLLC
• Yessica Rosales, DC
• Caleb Rose, APRN
• Darren C Rose, PT
• Dona Rose, DO
• Tracy Rose
• Rosemary Birthing Home, Inc.
• Rose Rosen, LMHC
• James Allen Rosenbaum, LMT
• Seth I Rosenberg, MD

• Surgical Physician Assistant in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.