Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Ann Hallissey, PA-C

Individual provider Physician Assistant · NPI 1922741933

Kelly Ann Hallissey, PA-C is a Physician Assistant in Tampa, Florida. Graduated from Florida State University College of Medicine in 2021, 5 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Trained at
Florida State University College of Medicine
Licensed in
FL
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (813) 745-7365
Fax: (813) 449-8618
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6310 Health Park Way Ste 330, Lakewood Ranch, FL 34202-5177 — (941) 359-8900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9115613 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 9115613 (FL)

Record details

NPI number1922741933
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 18, 2022
Last updated in NPPESApril 2, 2025
Certification dateApril 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolFLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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