Individual provider Active NPI

Kelsea Lydon, PA-C

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1659993103
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9113335 Issued in FL
Practice address
9430 Turkey Lake Rd Ste 114
Orlando, FL 32819-8015
Phone
(407) 354-1202
Fax
(407) 351-8801
NPI assigned
May 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9113335 FL Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

9430 Turkey Lake Rd Ste 114
Orlando, FL 32819-8015

Mailing address

9430 Turkey Lake Rd Ste 114
Orlando, FL 32819-8015
Phone (407) 354-1202

Other practice location 1

7575 Dr Phillips Blvd Ste 10
Orlando, FL 32819-7221
Phone (407) 543-6402

Other practice location 2

219 3rd St
Winter Garden, FL 34787-3609
Phone (503) 807-5531

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
I20251019000022 FL Practitioner - Physician Assistant 5991293342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

9430 Turkey Lake Rd
Suite 114
Orlando, FL 32819-8015
Phone (407) 354-1202

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2025 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9430 Turkey Lake Rd
Ste 114
Orlando, FL 32819
Phone (407) 354-1202

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1659993103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 TURKEY LAKE RD STE 114",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198015",
            "telephone_number": "407-354-1202",
            "fax_number": "407-351-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 TURKEY LAKE RD STE 114",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198015",
            "telephone_number": "407-354-1202",
            "fax_number": "407-351-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7575 Dr Phillips Blvd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197221",
            "country_code": "US",
            "telephone_number": "407-543-6402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "219 3rd St",
            "address_purpose": "LOCATION",
            "city": "Winter Garden",
            "state": "FL",
            "postal_code": "347873609",
            "country_code": "US",
            "telephone_number": "503-807-5531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYDON",
        "first_name": "KELSEA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9113335",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.