HEATHER LACY (PA) – Physician Assistant, NPI 1235775453

HEATHER LACY (PA) is a healthcare provider. based in Fort myers, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA112700 (FL). The NPI Number for HEATHER LACY (PA) is 1235775453

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
HEATHER LACY (PA)
NPI
1235775453
Phone
(239) 274-8200
Address
4371 VERONICA S SHOEMAKER BLVD
Enumeration Date
22 November 2019
Last Update Date
22 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9317872940
Graduation Year
2019 (7 years ago)
PAC ID
5092149476
Group Practice PAC ID
2466988308
Professional Enrollment ID
I20191217002420
Address ID
FL325036436PE3001XSTXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for HEATHER LACY (PA)

  • 4371 VERONICA S SHOEMAKER BLVD

    FORT MYERS, FL 339162216

    Phone: (239) 274-8200

    Type: Mailing

  • 6310 HEALTH PARK WAY STE 200

    LAKEWOOD RANCH, FL 342025177

    Phone: (941) 907-4737

    Fax: (941) 907-9493

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $69.

Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.

Last reported payment date: 2024-04-10 • Largest payer in this snapshot: Pharmacyclics LLC, an AbbVie Company ($27).

Total Amount

$69

General + Research + Ownership

Payments

3

Total payment records

General Amount

$69

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-12-17

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191217002420IPhysician AssistantFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33916)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466988308View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerFL
Nurse PractitionerFL
H O S P I T A L I S TIL
Nurse PractitionerFL
Nurse PractitionerFL
Physician AssistantFL
Nurse PractitionerFL
Physician AssistantNY
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is HEATHER LACY (PA)'s NPI number?
HEATHER LACY (PA)'s NPI is 1235775453 — the number used across U.S. healthcare to identify this provider.
Is there an active status for HEATHER LACY (PA)?
For scheduling context, HEATHER LACY (PA) is shown as active in the registry.
How would a patient describe HEATHER LACY (PA)'s focus?
For HEATHER LACY (PA), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Is HEATHER LACY (PA) associated with Fort Myers?
Public fields place HEATHER LACY (PA) around Fort Myers, Florida. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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