Kylie Jo Wood Fontoura, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9109711 Issued in FL

Practice address

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926

Phone

(813) 779-6303

NPI assigned

Sep 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Riverview Hospital, Riverview, FL, CCN 100364

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare 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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment Care Compare group
• Adventist Health System-Sunbelt Inc

  • Family Medicine Physician
  • Wauchula, FL
  • NPI 1578725941
  Medicare reassignment NPD
• Adventist Health System-Sunbelt Inc

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Medicare reassignment
• American Current Care PA

  • Urgent Care Clinic/Center
  • Pinecrest, FL
  • NPI 1770719296
  Medicare reassignment
• Adventist Health System-Sunbelt Inc

  • Rural Health Clinic/Center
  • Avon Park, FL
  • NPI 1881850956
  NPD
• Adventist Health System-Sunbelt Inc

  • Internal Medicine Physician
  • Sebring, FL
  • NPI 1164698809

  Hospitalist

  NPD (past)

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

• Adventhealth Riverview Inc

  • General Acute Care Hospital
  • Riverview, FL
  • NPI 1699345314
  Care Compare affiliation

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1841541182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "509-453-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 E Nob Hill Blvd",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989013534",
            "country_code": "US",
            "telephone_number": "509-248-3334",
            "fax_number": "509-453-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD FONTOURA",
        "first_name": "KYLIE",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "PA9109711",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Richard Witt, DMD PA
• Andrea Wojcichowsky, PT
• Nancy Wolf
• Brent Maddox Womble, PHD
• Lawrence Wong
• Catherine Leigh Wood, RCSWI, GC-C
• Leticia S Worsham, PA
• Abraham Tareq Yacoub, MD
• Elizabeth Yakubu, MD
• Christopher James Yanichko, DO

• Physician Assistant in Temple Terrace, FL
• Providers in Temple Terrace, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.