Individual provider Active NPI

Hayley Hasty Lesuer, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1366684318
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01931 Issued in NC
Practice address
11840 Southmore Dr Ste 100
Charlotte, NC 28277-4821
Phone
(980) 308-0169
Fax
(980) 308-0173
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 005603 GA
Physician Assistant 363A00000X 0010-01931 NC Primary

Addresses

Primary practice location

11840 Southmore Dr Ste 100
Charlotte, NC 28277-4821

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 562-0409

Other identifiers 1

IdentifierTypeStateIssuer
0828PAMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hlesuer883541@direct.novanthealth.org

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
I20100724000072 NC Practitioner - Physician Assistant 1052465440 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

15235 John J Delaney Dr
Suite B
Charlotte, NC 28277-2846
Phone (704) 243-8937

445 S Kings Dr
Charlotte, NC 28204-3041
Phone (980) 308-0141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-01931NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 1, 2021 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince May 1, 2021 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince May 1, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 1, 2021 Accepting new patients
Memorial Health Urgentone, Inc. Physician Assistant Past Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients

Locations

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

11840 Southmore Dr
Ste 100
Charlotte, NC 28277
Phone (704) 316-4440

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: hlesuer428473@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: hlesuer883541@direct.novanthealth.org

Organizations & group practices 10

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1366684318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11840 SOUTHMORE DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774821",
            "telephone_number": "980-308-0169",
            "fax_number": "980-308-0173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10628 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-562-0409",
            "fax_number": "912-350-2145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESUER",
        "first_name": "HAYLEY",
        "middle_name": "HASTY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005603",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0828PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hlesuer883541@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "11840 Southmore Dr Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282774821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.