CARLY TANNER (PA) – Physician Assistant, NPI 1033416565
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for CARLY TANNER (PA)
151 SOUTHHALL LN
STE 300
MAITLAND, FL 327517176
Phone: (407) 875-2080
Fax: (407) 650-3455
Type: Mailing
2835 W DE LEON ST STE 103
TAMPA, FL 336094130
Phone: (813) 875-7333
Fax: (813) 875-8833
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 153 Open Payments records for all available years, with a total value of $3,831.
Total Amount is formed as General ($3,831) + Research ($0) + Ownership ($0) = $3,831.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($1,194).
Total Amount
$3,831
General + Research + Ownership
Payments
153
Total payment records
General Amount
$3,831
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,194 |
| PFIZER INC. | $492 |
| Janssen Biotech, Inc. | $367 |
| E.R. Squibb & Sons, L.L.C. | $214 |
| GENZYME CORPORATION | $195 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-06-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110630000261 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 476 | 86 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 230 | 145 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 153 | 99 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 111 | 87 | $0 |
| 11103 | Biopsy of related skin growth, each additional growth | 64 | 34 | $0 |
Insurance plans in this area (ZIP 32751)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NV | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | FL | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | FL | |
| - | FL | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | FL | |
| - | TX |
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