Individual provider Active NPI

Alexandra Seaborg Bare

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1346038643
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-16195 Issued in NC
Practice address
15830 Ballantyne Medical PL Ste 175
Charlotte, NC 28277-0763
Phone
(704) 323-7633
Fax
(704) 709-5384
NPI assigned
Apr 28, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-16195 NC Primary

Addresses

Primary practice location

15830 Ballantyne Medical PL Ste 175
Charlotte, NC 28277-0763

Mailing address

15830 Ballantyne Medical PL Ste 175
Charlotte, NC 28277-0763
Phone (704) 323-7633

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
I20260309000294 NC Practitioner - Physician Assistant 1052894045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists of the Carolinas PLLCGroup PAC ID 0648178020, 78 clinicians

Practice addresses (Care Compare)

101 E W T Harris Blvd
Suite 5201
Charlotte, NC 28262-3422
Phone (704) 547-1495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-16195NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialists of the Carolinas PLLC CurrentSince Mar 30, 2026 Accepting new patients

Locations

15830 Ballantyne Medical Pl
Ste 175
Charlotte, NC 28277
Phone (704) 323-7633

101 E Wt Harris Blvd
Ste 5201
Charlotte, NC 28262
Phone (704) 547-1495

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1346038643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15830 BALLANTYNE MEDICAL PL STE 175",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770763",
            "telephone_number": "704-323-7633",
            "fax_number": "704-709-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 BALLANTYNE MEDICAL PL STE 175",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770763",
            "telephone_number": "704-323-7633",
            "fax_number": "704-709-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARE",
        "first_name": "ALEXANDRA",
        "middle_name": "SEABORG",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-04-28",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.