| Lacie Manthripragada, PA-C | |
|
615 E Princeton St Ste 101, Orlando, FL 32803-1435 | |
| (407) 236-0006 | |
| (407) 236-0007 |
| Full Name | Lacie Manthripragada |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 13 Years |
| Location | 615 E Princeton St Ste 101, Orlando, 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 |
|---|---|---|---|
| 1982018024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | C05294 (Maryland) | Secondary |
| 363A00000X | Physician Assistant | PA9112408 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Luminis Health Anne Arundel Medical Center, Inc | Annapolis, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Luminis Health Medical Group, Llc | 2860447315 | 540 |
| Entity Name | Johns Hopkins University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922008549 PECOS PAC ID: 8921903147 Enrollment ID: O20031215000719 |
| Entity Name | Maryland General Clinical Practice Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770684805 PECOS PAC ID: 8123926649 Enrollment ID: O20041109000226 |
| Entity Name | Luminis Health Medical Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073580205 PECOS PAC ID: 2860447315 Enrollment ID: O20050317000146 |
| Mailing Address | Practice Location Address |
|---|---|
| Lacie Manthripragada, PA-C 615 E Princeton St Ste 101, Orlando, FL 32803-1435 Ph: (407) 236-0006 | Lacie Manthripragada, PA-C 615 E Princeton St Ste 101, Orlando, FL 32803-1435 Ph: (407) 236-0006 |
Valerie Lynn Poirier, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1512 W Colonial Dr, Orlando, FL 32804 Phone: 407-423-1768 |
Lauren C. Meador, PA-C. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1400 S Orange Ave, Orlando, FL 32806 Phone: 407-648-3800 |
Mrs. Jean Fairchild Blythe, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5979 Vineland Rd Ste 101, Orlando, FL 32819 Phone: 407-355-3120 Fax: 407-355-3119 |
Ernest Chi Kong Ng, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 615 E Princeton St Ste 310, Orlando, FL 32803 Phone: 407-303-5781 Fax: 407-303-5794 |
Madison Julia Marcano, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1400 S Orange Ave, Orlando, FL 32806 Phone: 321-843-8010 Fax: 321-843-6330 |
Victoria Jean Treiber, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6057 Lake Pointe Dr Apt 410, Orlando, FL 32822 Phone: 407-952-1903 |
Mr. Morris C Evans, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5881 Turkey Lake Rd, Orlando, FL 32819 Phone: 407-224-2273 Fax: 407-264-6494 |