Individual provider Active NPI

Austin Keith Lipsey, PA-C

  • Physician Assistant
  • North Haven, CT
National Provider Identifier
1114652559
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
370 Bassett Rd
North Haven, CT 06473-4201
Phone
(203) 582-7766
NPI assigned
Jul 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-12945 NC
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

370 Bassett Rd
North Haven, CT 06473-4201

Mailing address

370 Bassett Rd
North Haven, CT 06473-4201
Phone (203) 582-7766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230228002188 NC Practitioner - Physician Assistant 1850764572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Prep II LLCGroup PAC ID 1052835311, 47 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 300
Charlotte, NC 28207-1112
Phone (704) 333-0741

7300 Carmel Executive Park Dr
Suite 200
Charlotte, NC 28226-1336
Phone (704) 364-8104

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-12945NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Prep II LLC CurrentSince Apr 1, 2025 Accepting new patients
Novant Health Prep II LLC CurrentSince Apr 1, 2025 Accepting new patients
Southeast Surgical Specialists, PLLC Past Accepting new patients

Locations

2001 Vail Ave
Ste 320
Charlotte, NC 28207
Phone (704) 333-0741

7300 Carmel Executive Park Dr
Ste 200
Charlotte, NC 28226
Phone (704) 364-8100

1918 Randolph Rd
Ste 300
Charlotte, NC 28207
Phone (704) 333-0741

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1114652559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 BASSETT RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064734201",
            "telephone_number": "203-582-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 BASSETT RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064734201",
            "telephone_number": "203-582-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSEY",
        "first_name": "AUSTIN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12945",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

Verify at the official NPI Registry.