Kevin K Carlisle, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA1682 Issued in FL

Practice address

12880 Commodity PL
Tampa, FL 33626-3101

Phone

(813) 343-5500

Fax

(866) 462-7445

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Surgical Assistants, IncGroup PAC ID 0941295950, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Heartland Surgical Assistants, Inc

  • Physician Assistant
  • Winter Haven, FL
  • NPI 1689764763
  Medicare reassignment Care Compare group Authorized official
• Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
  • NPI 1497748743
  Medicare reassignment NPD
• L Francisco Espaillat MD PA

  • Surgery Physician
  • Sebring, FL
  • NPI 1467683771
  NPD (past)
• Southeastern Clinical Services,Inc.

  • Surgical Physician Assistant
  • Orlando, FL
  • NPI 1033162011
  NPD (past)

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

• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1669467833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21686",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336221686",
            "telephone_number": "813-343-5500",
            "fax_number": "866-462-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 COMMODITY PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263101",
            "telephone_number": "813-343-5500",
            "fax_number": "866-462-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-687-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "KEVIN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA1682",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA1682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "650420578",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X1592",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290188900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caringathome, LLC
• Carla Cares07 LLC
• Faith Carlin, MD
• Tobias Je Carling, MD, PHD
• Christopher John Carlisle, PA-C
• Carlos a, Solorzano
• Carlos Alberto Silva MD PA (Advanced Primary Care)
• Carlos B Pagan MD
• Jetlexis Carlos
• Abby Carlson

• Surgical Physician Assistant in Tampa, FL
• Providers in Tampa, 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 Mar 4, 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.