| Kaela Bacon, PA | |
|
12902 Usf Magnolia Dr, Tampa, FL 33612-9416 | |
| (813) 745-7365 | |
| (813) 449-8618 |
| Full Name | Kaela Bacon |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 9 Years |
| Location | 12902 Usf Magnolia Dr, Tampa, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164930616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9110761 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| H Lee Moffitt Cancer Center & Research Institute I | Tampa, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc | 2264337021 | 1145 |
| Fmc Urgent Care Llc | 7618166984 | 21 |
| Entity Name | H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306833595 PECOS PAC ID: 2264337021 Enrollment ID: O20031204000575 |
| Entity Name | Fmc Urgent Care LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154563120 PECOS PAC ID: 7618166984 Enrollment ID: O20110118001226 |
| Entity Name | Memon Health Associates, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891164398 PECOS PAC ID: 7416257860 Enrollment ID: O20160713001021 |
| Mailing Address | Practice Location Address |
|---|---|
| Kaela Bacon, PA Po Box 198441, Atlanta, GA 30384-8441 Ph: (813) 745-7365 | Kaela Bacon, PA 12902 Usf Magnolia Dr, Tampa, FL 33612-9416 Ph: (813) 745-7365 |
Sara Elizabeth Udani, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10150 Highland Manor Dr Ste 205, Tampa, FL 33610 Phone: 813-259-1013 Fax: 813-254-0396 |
Randi Marie Bustin, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1502 E Fowler Ave, Tampa, FL 33612 Phone: 813-866-0950 Fax: 813-866-0929 |
Mrs. Jennifer Rose Baker Koebert, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4001 E Fletcher Ave Fl 6, Tampa, FL 33613 Phone: 813-396-0768 |
Frances Ivelisse Bernardo Mercado, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 813-745-4673 |
Maheen Rahim Jussab Ismail, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 888-663-3488 |
Tracie L Patel, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10740 Palm River Rd Ste 360, Tampa, FL 33619 Phone: 813-844-7585 Fax: 813-844-5877 |
Mr. Anthony Bromagen, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12880 Commodity Pl, Tampa, FL 33626 Phone: 813-343-5500 Fax: 813-343-5506 |