Heartland Surgical Assistants, Inc

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1682 Issued in FL

Legal business name

HEARTLAND SURGICAL ASSISTANTS, INC

Practice address

200 Avenue F NE
Winter Haven, FL 33881-4131

Phone

(863) 381-7647

NPI assigned

Oct 13, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin K Carlisle, PACNPI 1669467833

Title

President

Phone

(863) 381-7632

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin K Carlisle, P.A.

  • Surgical Physician Assistant
  • Tampa, FL
  • NPI 1669467833
  Medicare reassignment Care Compare group Authorized official
• Erichsen R Bonostro, PAC

  • Surgical Physician Assistant
  • Lakeland, FL
  • NPI 1902170327
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689764763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 LAKE DEESON WOODS CT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338057638",
            "telephone_number": "863-381-7632",
            "fax_number": "863-606-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-381-7647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Sun N Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "338721986",
            "country_code": "US",
            "telephone_number": "863-471-1413",
            "fax_number": "863-471-1416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-381-7647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARTLAND SURGICAL ASSISTANTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-381-7632",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA1682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA4132",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "X1592",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Healy
• Hearing Consultants
• Claude A Hearn, DMD, P.A.
• Heart of Gold Senior Services
• Heartland Community Church, Inc. (Heartland Counseling Center)
• Thomas W Hegland, O.D.
• Helpful Hearts Care Solutions LLC
• Cassandra Hemby, APRN
• Rosa Jhanell Hemmings
• Kevin L Henne, OD

• Physician Assistant in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.