Kelli K Thomazin, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9113657 Issued in FL

Practice address

773 Stirling Center PL
Lake Mary, FL 32746-4856

Phone

(407) 977-4130

Fax

(407) 977-4139

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NE, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians

Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Greater Orlando Orthopedic GroupGroup PAC ID 6608128863, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Oviedo Medical Center Hospital, Oviedo, FL, CCN 100329

Merit-based Incentive Payment System (MIPS)

Final score

65.67 of 100Reported as group

Quality

95

Promoting interoperability

0

Improvement activities

40

Cost

73.89

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Greater Orlando Orthopedic Group

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Lake Mary, FL
  • NPI 1376020743
  Medicare reassignment Care Compare group
• Columbus Community Hospital Inc

  • Surgery Physician
  • Columbus, NE
  • NPI 1821592205
  Medicare reassignment

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

• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Oviedo Medical Center, LLC

  • General Acute Care Hospital
  • Oviedo, FL
  • NPI 1245785567
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1780637504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 STIRLING CENTER PL",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464856",
            "telephone_number": "407-977-4130",
            "fax_number": "407-977-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 STIRLING CENTER PL",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464856",
            "telephone_number": "407-977-4130",
            "fax_number": "407-977-4139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7974 Lake Underhill Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328228229",
            "country_code": "US",
            "telephone_number": "407-977-4130",
            "fax_number": "407-977-4139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7404 Red Bug Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327657154",
            "country_code": "US",
            "telephone_number": "407-977-4130",
            "fax_number": "407-977-4139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAZIN",
        "first_name": "KELLI",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1029",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1029",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "1029",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9113657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Lake Mary, FL
• Providers in Lake Mary, 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 Nov 7, 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.
• 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.