Individual provider Active NPI

Bryan Lesniewicz, PA-C

  • Physician Assistant
  • Louisa, VA
National Provider Identifier
1760163133
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009556 Issued in VA
Practice address
575 Industrial Dr
Louisa, VA 23093-4146
Phone
(540) 967-2011
Fax
(540) 967-2982
NPI assigned
Jul 28, 2023
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 0110009556 VA Primary

Addresses

Primary practice location

575 Industrial Dr
Louisa, VA 23093-4146

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240205002911 VA Practitioner - Physician Assistant 3173966397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intercept Youth Services IncGroup PAC ID 2466748744, 4 clinicians

Practice addresses (Care Compare)

5673 Airport Rd
Roanoke, VA 24012-1119
Phone (540) 523-8055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1185614VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 13, 2026 Accepting new patients
Intercept Youth Services, Inc CurrentSince Nov 27, 2023 Accepting new patients
Uva Community Health Medical Group, LLC PastSince Aug 13, 2026 Accepting new patients

Locations

10187 Brook Rd
Glen Allen, VA 23059
Phone (540) 523-8080

575 Industrial Dr
Louisa, VA 23093
Phone (540) 967-2011

5673 Airport Rd NW
Roanoke, VA 24012
Phone (540) 523-8055

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1760163133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 INDUSTRIAL DR",
            "city": "LOUISA",
            "state": "VA",
            "postal_code": "230934146",
            "telephone_number": "540-967-2011",
            "fax_number": "540-967-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESNIEWICZ",
        "first_name": "BRYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, VA

Sources for this page

Verify at the official NPI Registry.