Individual provider Active NPI

Lauren Fago

  • Physician Assistant
  • Lithia, FL
National Provider Identifier
1699428680
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13837 Circa Crossing Drive
Lithia, FL 33547
Phone
(813) 684-2663
Fax
(813) 658-6222
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

13837 Circa Crossing Drive
Lithia, FL 33547

Mailing address

PO Box 850001 Dept 8272
Orlando, FL 32885-8272
Phone (813) 684-2663

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
I20220210002423 FL Practitioner - Physician Assistant 0749673929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Medical Group of Tampa Bay PAGroup PAC ID 9436220415, 34 clinicians

Practice addresses (Care Compare)

10740 Palm River Rd
Suite 310
Tampa, FL 33619-4577
Phone (813) 684-2663

13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone (813) 535-6647

414 N Plant Ave
Plant City, FL 33563-7248
Phone (813) 684-2663

420 N Plant Ave
Plant City, FL 33563-7248
Phone (813) 684-2663

4541 S Dale Mabry Hwy
Suite 200
Tampa, FL 33611-1407
Phone (813) 684-2663

6901 Simmons Loop
Riverview, FL 33578-9498
Phone (813) 302-8000

7239 Paradiso Dr
Apollo Beach, FL 33572-1637
Phone (813) 684-2663

Hospital & facility affiliations

  • South Florida Baptist Hospital Hospital, Plant City, FL, CCN 100132

National Provider Directory

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1699428680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001 DEPT 8272",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328858272",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DRIVE",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "33547",
            "telephone_number": "813-684-2663",
            "fax_number": "813-658-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGO",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

Verify at the official NPI Registry.