Individual provider Active NPI

Keith Brandon Haseley, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1386183994
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5566 Issued in SC
Practice address
319 Folly Rd
Charleston, SC 29412-2518
Phone
(843) 203-2246
Fax
(843) 203-2247
NPI assigned
Feb 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 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 020599 NY
Physician Assistant 363A00000X 5566 SC Primary

Addresses

Primary practice location

319 Folly Rd
Charleston, SC 29412-2518

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170323001028 NY Practitioner - Physician Assistant 7810272366 Reassigns benefits to 4 organizations
I20250711000460 SC Practitioner - Physician Assistant 7810272366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians

Practice addresses (Care Compare)

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

319 Folly Rd
Charleston, SC 29412-2518
Phone (843) 723-8823

3885 W Ashley Cir
Suite F600
Charleston, SC 29414-9273
Phone (843) 853-3474

Hospital & facility affiliations

  • Roper Hospital Hospital, Charleston, SC, CCN 420087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5566SCMDPhysical Therapist
020599NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jul 14, 2025 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jul 14, 2025 Accepting new patients
Western New York Immediate Medical Care LLC CurrentSince Dec 31, 2018 Accepting new patients
Advanced Care Physical Therapy Aquatics and Fitness PC PastSince Mar 30, 2024 Accepting new patients

Locations

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

7616 Transit Rd
Williamsville, NY 14221
Phone (716) 204-2273

319 Folly Rd
Charleston, SC 29412
Phone (843) 203-2246

8536 Palmetto Commerce Pkwy
Ste 501
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: khaseley2953174@direct.bsmhealth.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.

Hospital & facility affiliations 1

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": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1386183994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122518",
            "telephone_number": "843-203-2246",
            "fax_number": "843-203-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELEY",
        "first_name": "KEITH",
        "middle_name": "BRANDON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-15",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020599",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.