Keisha Marie Poleon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9117189 Issued in FL

Practice address

2919 W Swann Ave Ste 106
Tampa, FL 33609-4049

Phone

(813) 930-2829

Fax

(813) 930-9522

NPI assigned

Mar 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• West Central Gastroenterology LLP

  • Gastroenterology Physician
  • Clearwater, FL
  • NPI 1144454703
  Medicare reassignment
• Gastro Florida Pharmacy, LLC

  • Pharmacy
  • Clearwater, FL
  • NPI 1285272815
  NPD (past)

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1699478123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 HUNTERS VILLAGE RD UNIT 361",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473809",
            "telephone_number": "256-426-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 W SWANN AVE STE 106",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094049",
            "telephone_number": "813-930-2829",
            "fax_number": "813-930-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEON",
        "first_name": "KEISHA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R6341",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118654700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "WN769",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Evelyn Polcz, MD
• Joshua Robert Polege, A.A.
• Donna Polelle, CCC-SLP
• Allison Ilene Polender, M.D.
• Kaila Poleon
• Megan Lanay Polin, BS
• Katrina Polite
• Douglas E. Politz, M.D.
• Kaila Jean Polizzi, MD
• Jazmyn Polk

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.