Individual provider Active NPI

Cara C Cimilluca, PA-C

  • Medical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1972610020
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104283 Issued in FL
Practice address
1839 Central Ave
St Petersburg, FL 33713-9089
Phone
(727) 322-1054
Fax
(727) 322-2725
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104283 FL Primary
Surgical Physician Assistant 363AS0400X PA9104283 FL
Physician Assistant 363A00000X

Addresses

Primary practice location

1839 Central Ave
St Petersburg, FL 33713-9089

Mailing address

1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054

Other identifiers 2

IdentifierTypeStateIssuer
8N7446OtherTXBLUE SHILD
292828100MedicaidFL

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
I20260209002586 FL Practitioner - Physician Assistant 2163472044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia Col of Osteo Med, Sewanee, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Health Care of Pinellas, LLCGroup PAC ID 1658274675, 88 clinicians

Practice addresses (Care Compare)

1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104283FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas LLC CurrentSince Feb 5, 2026 Accepting new patients
Suncoast Pace, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Professional Health Care of Pinellas Inc. CurrentSince Feb 5, 2026 Accepting new patients

Locations

6774 102nd Ave N
Pinellas Park, FL 33782
Phone (727) 289-0062

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

Organizations & group practices 3

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1972610020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337139089",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337139089",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMILLUCA",
        "first_name": "CARA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104283",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104283",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHILD",
            "identifier": "8N7446",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292828100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.