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

Mr. Kevin K Carlisle, PA

Individual provider Physician Assistant · NPI 1669467833

Mr. Kevin K Carlisle, PA is a Physician Assistant in Tampa, Florida. Qualified in 1980, 46 years ago. Practices with Heartland Surgical Assistants, Inc, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
46
Licensed in
FL
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

12880 Commodity Pl
Tampa, FL 33626-3101
Phone: (813) 343-5500
Fax: (866) 462-7445
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 — (863) 687-1100

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA1682 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA1682 (FL)

Record details

NPI number1669467833
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedSeptember 14, 2005
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1980 (46 years in practice)
Group practice Heartland Surgical Assistants, Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Tampa