MR. WILLIAM TRAVIS FANN (MS,ATC,PA-C) – Physician Assistant, NPI 1962667881
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
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Provider Addresses for MR. WILLIAM TRAVIS FANN (MS,ATC,PA-C)
3030, Harden Boulevard, Lakeland, Polk County, Florida, 33803, United States
LAKELAND, FL 338037952
Phone: (863) 687-1250
Fax: (863) 687-1258
Type: Location
Lakeland Regional Health Medical Center, 1324, Lakeland Hills Boulevard, Lakeland, Polk County, Florida, 33805, United States
MANAGED CARE DEPT.
LAKELAND, FL 338054543
Phone:
Type: Mailing
13837 CIRCA CROSSING DR
LITHIA, FL 335474382
Phone: (813) 684-2663
Fax: (813) 658-6222
Type: Mailing
615 VONDERBURG DR
BRANDON, FL 335115972
Phone: (813) 684-2663
Fax: (813) 658-6222
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $350.
Total Amount is formed as General ($350) + Research ($0) + Ownership ($0) = $350.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Stryker Corporation ($335).
Total Amount
$350
General + Research + Ownership
Payments
4
Total payment records
General Amount
$350
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 |
|---|---|
| Stryker Corporation | $335 |
| Orthofix Medical, Inc. | $14 |
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: 2019-02-07
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 |
|---|---|---|---|---|
| I20190207000666 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19 | 19 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 17 | 17 | $0 |
| 73562 | X-ray of knee, 3 views | 14 | 14 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 11 | 11 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 33803)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | MD | |
| - | FL | |
| Orthopedic Surgery | PA | |
| Orthopedic Surgery | FL | |
| Sports Medicine, Orthopedic Surgery | FL | |
| - | FL | |
| Physical Therapist In Private Practice | FL | |
| Sports Medicine, Orthopedic Surgery | OR | |
| - | FL | |
| Physician Assistant | FL |
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