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: July 19, 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 maintains a secondary practice location in Lakeland.Information from the official NPPES registry record, last updated March 4, 2026.

NPPES Registry Identity

NPI1669467833
Entity TypeIndividualMale
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
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. How NPI validation works

Primary Specialty

Physician Assistant · Surgical

Taxonomy 363AS0400X · Physician Assistants & Advanced Practice Nursing Providers

Licensed in FL · PA1682

Also Listed

Physician Assistant

Taxonomy 363A00000X · Physician Assistants & Advanced Practice Nursing Providers

Licensed in FL · PA1682
12880 COMMODITY PL, Tampa, FL 33626

Also on File with NPPES

Secondary Location1
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100
Other Identifiers3
650420578 (Other, FL, Champus/tricare)
X1592 (Other, FL, Blue Cross Blue Shield)
290188900 (Medicaid, FL)

Medicare Participation & PECOS Enrollment Status

Kevin Carlisle is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kevin Carlisle is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2769477785

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040419001106

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kevin Carlisle is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LAKELAND REGIONAL MEDICAL CENTER1324 LAKELAND HILLS BLVD
LAKELAND, FL 33805
(863) 687-1100Acute Care Hospitals

Reviews for MR. KEVIN K CARLISLE P.A.

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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physician Assistant (Surgical)
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Surgery
12880 COMMODITY PL
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL
TAMPA, FL 33626
Surgery
12880 COMMODITY PL
TAMPA, FL 33626
Surgery
12880 COMMODITY PL
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Registered Nurse (Registered Nurse First Assistant)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Surgery
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS
TAMPA, FL 33626
Surgery
12880 COMMODITY PL
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS
TAMPA, FL 33626
Surgery
12880 COMMODITY PL, CARE OF UNITED SURGICAL ASSISTANTS, INC.
TAMPA, FL 33626
Registered Nurse (Registered Nurse First Assistant)
12880 COMMODITY PL, C/O UNITED SURGICAL ASSISTANTS, INC
TAMPA, FL 33626
Physician Assistant (Surgical)
12880 COMMODITY PL, CARE OF USA SURGICAL SERVICES CT, P.C.
TAMPA, FL 33626
Registered Nurse (Registered Nurse First Assistant)
12880 COMMODITY PL
TAMPA, FL 33626

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669467833, enumerated as an "individual" on September 14, 2005.

The provider is located at 12880 COMMODITY PL TAMPA, FL 33626 and the phone number is (813) 343-5500.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

The provider might be accepting Accepts: Tricare, Medicare, Medicaid and Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.

Kevin Carlisle is affiliated with: LAKELAND REGIONAL MEDICAL CENTER.