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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. LACEY ELISSA ROSE PA
NPI 1629839709
Physician Assistant - Surgical in Sarasota, FL

Active since January 17, 2024PECOS EnrolledAccepts Medicare Assignment
1700 S TAMIAMI TRL, SARASOTA, FL 34239(941) 917-7494(941) 917-7739 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Lacey Elissa Rose Pa NPPES

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

MRS. LACEY ELISSA ROSE PA (NPI 1629839709) is an individual surgical provider in Sarasota, Florida, licensed in Florida (PA9120077) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS, is affiliated with Sarasota Memorial Hospital, and maintains a secondary practice location in Bay Shore.

NPPES Registry Identity

NPI1629839709
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMRS. LACEY ELISSA ROSECredential: PA
Location Address1700 S TAMIAMI TRLSarasota, FL 34239-3509
Mailing AddressPo Box 947407Atlanta, GA 30394-7407 · (941) 917-2600 · Fax (941) 917-7884
Phone(941) 917-7494
Fax(941) 917-7739
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 17, 2024
Last NPPES UpdateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
✔ NPI 1629839709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Licenses✔ Licensed in FL · PA9120077✔ Licensed in NY · 031360
1700 S TAMIAMI TRL, Sarasota, FL 34239
Open in Google Maps ↗

Secondary Practice Location 1

Location 1301 E Main StBay Shore, NY 11706-8408 · Phone (631) 968-3000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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

Mrs. Lacey Elissa Rose 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 ID6103267109
PECOS Enrollment IDI20240508001786, I20250826003796
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sarasota Memorial Hospital

Acute Care Hospitals · Sarasota, FL
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100087
Location1700 S Tamiami TrlSarasota, FL 34239 · Sarasota County
Emergency services Birthing friendly

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.

DR. ELIJAH KIM M.D.
Surgery (Surgical Critical Care)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-9000
DR. ENRICO V VINTAYEN MD
Psychiatry & Neurology (Neurology)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-4896
VIRALKUMAR PATEL MD
Internal Medicine
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-4896
DR. MAHA HAMEED MBBS
Student in an Organized Health Care Education/Training Program
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-7799
ELIZABETH FERNANDEZ PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 262-7727
RODES ACKERMAN PHARMD
Pharmacist
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-3131
MAYURI JINDAL M.D.
Pediatrics
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-7490
STEVEN MICHAEL PAPUCHIS DO
Physical Medicine & Rehabilitation (Sports Medicine)
1700 S TAMIAMI TRL
SARASOTA, FL 34239
Sarasota County (941) 917-8561

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 Lacey Rose's NPI number?

The NPI number for Lacey Rose is 1629839709. It was assigned to this individual provider in the NPPES registry on January 17, 2024.

Where is Lacey Rose located?

Lacey Rose practices at 1700 S Tamiami Trl, Sarasota, FL 34239. The listed phone number is (941) 917-7494.

What is Lacey Rose's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Lacey Rose enrolled in Medicare?

Yes. Lacey Rose 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.

What insurance does Lacey Rose accept?

Health plans from UnitedHealthcare list Lacey Rose as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lacey Rose affiliated with any hospitals?

According to CMS data, Lacey Rose is affiliated with Sarasota Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Lacey Rose was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.