Individual provider Active NPI

Peyton Steven Beisecker, PA-C

  • Physician Assistant
  • Hartsville, SC
National Provider Identifier
1689541898
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone
(843) 339-2100
NPI assigned
Oct 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X SC Primary

Addresses

Primary practice location

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710

Mailing address

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone (843) 339-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20260325000032 SC Practitioner - Physician Assistant 4880178169 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
Ies South Carolina LLCGroup PAC ID 1355705070, 16 clinicians

Practice addresses (Care Compare)

1304 W Bobo Newsom Hwy
Hartsville, SC 29550-4710
Phone (469) 340-1366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1689541898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 W BOBO NEWSOM HWY",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504710",
            "telephone_number": "843-339-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W BOBO NEWSOM HWY",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504710",
            "telephone_number": "843-339-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEISECKER",
        "first_name": "PEYTON",
        "middle_name": "STEVEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

Verify at the official NPI Registry.