KAELA BACON PA
NPI 1164930616
Physician Assistant in Tampa, FL

Active since January 18, 2018PECOS EnrolledAccepts Medicare Assignment
12902 USF MAGNOLIA DR, TAMPA, FL 33612(813) 745-7365(813) 449-8618 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 7, 2025, Jun 2, 2025, Dec 31, 2020 and 2 more (5 updates tracked since 2018).

About Kaela Bacon Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAELA BACON PA (NPI 1164930616) is an individual physician assistant in Tampa, Florida, licensed in Florida (PA9110761) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1164930616
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKAELA BACONCredential: PA
Location Address12902 USF MAGNOLIA DRTampa, FL 33612-9416
Mailing AddressPo Box 198441Atlanta, GA 30384-8441 · (813) 745-7365 · Fax (813) 449-8618
Fax(813) 449-8618
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 18, 2018
Last NPPES UpdateAugust 7, 20255 updates tracked since enumeration
NPPES CertifiedAugust 7, 2025
NPI 1164930616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in FL · PA9110761
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

12902 USF MAGNOLIA DR, Tampa, FL 33612

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kaela Bacon Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830435734
PECOS Enrollment IDI20190115000388
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Simple complete removal of breast 19303
This procedure involves the total removal of breast tissue. It's typically done to treat or prevent conditions like cancer. The operation involves an incision on the skin, removal of the tissue, and closure of the wound. Post-surgery, care and recovery plans are provided.
13 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist (Oncology)
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Pharmacist (Oncology)
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Physician Assistant
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Anesthesiology (Pain Medicine)
12902 USF MAGNOLIA DR, WCB, 2ND FLOOR/ANESTHESIA
TAMPA, FL 33612
Anesthesiology
12902 USF MAGNOLIA DR, MCB-ANES
TAMPA, FL 33612
Nurse Anesthetist, Certified Registered
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Nurse Anesthetist, Certified Registered
12902 USF MAGNOLIA DR
TAMPA, FL 33612
Anesthesiology
12902 USF MAGNOLIA DR, MDC 44
TAMPA, FL 33612

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kaela Bacon's NPI number?

The NPI number for Kaela Bacon is 1164930616. It was assigned to this individual provider in the NPPES registry on January 18, 2018.

Where is Kaela Bacon located?

Kaela Bacon practices at 12902 Usf Magnolia Dr, Tampa, FL 33612. The listed phone number is (813) 745-7365.

What is Kaela Bacon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kaela Bacon enrolled in Medicare?

Yes. Kaela Bacon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kaela Bacon was last updated on August 7, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.