Kevin Lack, PA-C - Medicare Physician Assistant in Augusta, GA

Kevin Lack, PA-C is a medicare enrolled "Physician Assistant - Surgical" in Augusta, Georgia. He graduated from nursing school in 2004 and has 20 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Joseph M Still Burn Centers, Inc and his current practice location is 3675 J Dewey Gray Circle, Suite 300, Augusta, Georgia. You can reach out to his office (for appointments etc.) via phone at (706) 863-9595.

Kevin Lack is licensed to practice in Georgia (license number 4292) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1417924028.

Contact Information

Kevin Lack, PA-C
3675 J Dewey Gray Circle, Suite 300,
Augusta, GA 30909-1868
(706) 863-9595
(888) 745-3917

Map and Direction




Provider's Profile

Full NameKevin Lack
GenderMale
SpecialityPhysician Assistant
Experience20 Years
Location3675 J Dewey Gray Circle, Augusta, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kevin Lack graduated from nursing school in 2004
  NPI Data:
  • NPI Number: 1417924028
  • Provider Enumeration Date: 03/02/2006
  • Last Update Date: 06/03/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5890754147
  • Enrollment ID: I20041004000710

Medical Identifiers

Medical identifiers for Kevin Lack such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417924028NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical PA-1765 (Idaho)Secondary
363AS0400XPhysician Assistant - Surgical PA1198 (South Carolina)Secondary
363AS0400XPhysician Assistant - Surgical PA0000001669 (Tennessee)Secondary
363AS0400XPhysician Assistant - Surgical PA9106353 (Florida)Secondary
363AS0400XPhysician Assistant - Surgical 4292 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Doctors HospitalAugusta, GAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Joseph M Still Burn Centers, Inc761896363852

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kevin Lack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kevin Lack, PA-C
Po Box 3726,
Augusta, GA 30914-3726

Ph: (706) 863-9595
Kevin Lack, PA-C
3675 J Dewey Gray Circle, Suite 300,
Augusta, GA 30909-1868

Ph: (706) 863-9595

Reviews and Comments


Physician Assistant Nurses in Augusta, GA

Rachel Mccall Dawkins, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: Doctors Hospital Of Augusta, 3651 Wheeler Rd., Augusta, GA 30909
Phone: 706-651-6080    
Robert G Stowers, PA
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-3291    Fax: 706-721-1459
Mrs. Melanie Grace Bowen, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 2922 Professional Pkwy, Augusta, GA 30907
Phone: 706-556-2767    
Andrea N Sarata, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3675 J Dewey Gray Cir Ste 300, Augusta, GA 30909
Phone: 706-863-9595    Fax: 706-868-8375
Amanda Marie Tyra, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1120 15th St # Ad-2226, Augusta, GA 30912
Phone: 706-446-4887    Fax: 706-723-0382
Ms. Catherine Pringle, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1303 Dantignac St, Augusta, GA 30901
Phone: 706-821-2944    
Mr. Derek Aaron Lafont, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 3696 Wheeler Rd, Augusta, GA 30909
Phone: 706-736-1830    Fax: 706-650-7553

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.