Individual provider Active NPI

Kara Lockcuff, PA-C

  • Medical Physician Assistant
  • Maitland, FL
National Provider Identifier
1689448078
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9117996 Issued in FL
Practice address
430 Lake Howell Rd
Maitland, FL 32751-5907
Phone
(407) 636-3113
NPI assigned
Nov 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9117996 FL Primary

Addresses

Primary practice location

430 Lake Howell Rd
Maitland, FL 32751-5907

Mailing address

430 Lake Howell Rd
Maitland, FL 32751-5907
Phone (407) 636-3113

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
I20240429003598 FL Practitioner - Physician Assistant 3476993122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun State Dermatology LLCGroup PAC ID 9739543356, 3 clinicians

Practice addresses (Care Compare)

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

430 Lake Howell Rd
Maitland, FL 32751-5907
Phone (407) 636-3133

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2026 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2026 Accepting new patients

Locations

1905 Clint Moore Rd
Ste 103
Boca Raton, FL 33496
Phone (561) 241-4474

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

2955 Brownwood Blvd
Ste 204
The Villages, FL 32163
Phone (352) 571-7000

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

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 2

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": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1689448078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 LAKE HOWELL RD",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515907",
            "telephone_number": "407-636-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 LAKE HOWELL RD",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515907",
            "telephone_number": "407-636-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKCUFF",
        "first_name": "KARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.