Individual provider Active NPI

Colleen Lehane Ursic Newton, PA-C

  • Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1841668068
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9108889 Issued in FL
Practice address
655 N Clyde Morris Blvd Ste B
Daytona Beach, FL 32114-2321
Phone
(386) 252-5578
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 PA 9108889 FL Primary

Addresses

Primary practice location

655 N Clyde Morris Blvd Ste B
Daytona Beach, FL 32114-2321

Mailing address

18228 N US Highway 41
Lutz, FL 33549-4400
Phone (813) 321-1786

Other names 1

  • Colleen Lehane Ursic Former name

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
I20151221001731 FL Practitioner - Physician Assistant 9133420920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

655 N Clyde Morris Blvd
Suite B
Daytona Beach, FL 32114-2321
Phone (813) 321-1786

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9108889FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas K Pierce MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: c.ursic@directaddress.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1841668068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18228 N US HIGHWAY 41",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494400",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N CLYDE MORRIS BLVD STE B",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142321",
            "telephone_number": "386-252-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "COLLEEN",
        "middle_name": "LEHANE URSIC",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9108889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "URSIC",
            "middle_name": "LEHANE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.