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MR. KEVIN K CARLISLE P.A.
NPI 1669467833
Physician Assistant - Surgical in Tampa, FL

Active since September 14, 2005PECOS EnrolledAccepts Medicare Assignment
12880 COMMODITY PL, TAMPA, FL 33626(813) 343-5500(866) 462-7445 Get Directions Write a Review

NPPES record last updated: March 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Kevin K Carlisle P.a. NPPES

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

MR. KEVIN K CARLISLE P.A. (NPI 1669467833) is an individual surgical provider in Tampa, Florida, licensed in Florida (PA1682) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Lakeland Regional Medical Center, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1669467833
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. KEVIN K CARLISLECredential: P.A.
Location Address12880 COMMODITY PLTampa, FL 33626-3101
Mailing AddressPo Box 21686Tampa, FL 33622-1686 · (813) 343-5500 · Fax (866) 462-7445
Phone(813) 343-5500
Fax(866) 462-7445
Sole ProprietorYes
Medical School CMSOtherGraduated 1980
Enumeration DateSeptember 14, 2005
Last NPPES UpdateMarch 4, 2026
NPPES CertifiedMarch 4, 2026
✔ NPI 1669467833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in FL · PA1682
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA1682 (FL)
12880 COMMODITY PL, Tampa, FL 33626
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Other Identifiers 3

Other650420578FL · Champus/tricare
OtherX1592FL · Blue Cross Blue Shield
Medicaid290188900FL

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

Mr. Kevin K Carlisle P.a. 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 ID2769477785
PECOS Enrollment IDI20040419001106
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.

Lakeland Regional Medical Center

Acute Care Hospitals · Lakeland, FL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100157
Location1324 Lakeland Hills BlvdLakeland, FL 33805 · Polk 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.

MR. ANTHONY BROMAGEN PA
Physician Assistant (Surgical)
12880 COMMODITY PL
TAMPA, FL 33626
Hillsborough County (813) 343-5500
DR. GORDON W MCNEAL M.D.
Surgery
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Hillsborough County (877) 872-5788
MARIA ANN DAMBECK CRNFA
Registered Nurse (Registered Nurse First Assistant)
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Hillsborough County (877) 872-5788
ROBERT ENNES ALDRICH JR. PA-C
Physician Assistant (Surgical)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS
TAMPA, FL 33626
Hillsborough County (877) 872-5788
JOSHUA R WILLIAMS PA-C
Physician Assistant (Surgical)
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Hillsborough County (877) 872-5788
ANTONIO MARTINO MILLS PA-C
Physician Assistant (Surgical)
12880 COMMODITY PL
TAMPA, FL 33626
Hillsborough County (813) 343-5500
ANDREA LISA ENTIN RNFA
Registered Nurse (Registered Nurse First Assistant)
12880 COMMODITY PL
TAMPA, FL 33626
Hillsborough County (813) 343-5500
USA MEDICAL SERVICES PC
Surgery
12880 COMMODITY PL
TAMPA, FL 33626
Hillsborough County (877) 872-5788

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 Kevin Carlisle's NPI number?

The NPI number for Kevin Carlisle is 1669467833. It was assigned to this individual provider in the NPPES registry on September 14, 2005.

Where is Kevin Carlisle located?

Kevin Carlisle practices at 12880 Commodity Pl, Tampa, FL 33626. The listed phone number is (813) 343-5500.

What is Kevin Carlisle's specialty?

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

Is Kevin Carlisle enrolled in Medicare?

Yes. Kevin Carlisle 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.

Is Kevin Carlisle affiliated with any hospitals?

According to CMS data, Kevin Carlisle is affiliated with Lakeland Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Kevin Carlisle was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.