Individual provider Active NPI

Bret Thomas Loefstedt

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1770210106
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4573 Issued in SC
Practice address
115 State Park Rd
Greenville, SC 29609-2914
Phone
(864) 438-3500
Fax
(864) 438-3505
NPI assigned
Aug 5, 2022
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 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 4573 SC Primary

Addresses

Primary practice location

115 State Park Rd
Greenville, SC 29609-2914

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-0100
Phone (843) 792-1414

Other practice location 2

1671 Belle Isle Ave Ste 110J
Mount Pleasant, SC 29464-8336
Phone (844) 994-6633

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

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
I20221108003134 SC Practitioner - Physician Assistant 5597132316 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4573SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Oct 12, 2022 Accepting new patients
Musc Community Physicians CurrentSince Jan 1, 2026 Accepting new patients
Musc Community Physicians CurrentSince Jan 1, 2026 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Oct 12, 2022 Accepting new patients
Gomed, LLC PastSince Sep 5, 2017 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

169 Ashley Ave
Charleston, SC 29425
Phone (843) 792-3072

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

Interoperability endpoints

  • Direct secure messaging: bloefstedt368821@direct.musc.edu
  • Direct secure messaging: bret.loefstedt.1@22872.direct.athenahealth.com
  • Direct secure messaging: bret.loefstedt.p1@direct.scdc.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/22872/brand/2/csg/1/fhir/r4

Organizations & group practices 8

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": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1770210106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 STATE PARK RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296092914",
            "telephone_number": "864-438-3500",
            "fax_number": "864-438-3505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294250100",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1671 Belle Isle Ave Ste 110J",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294648336",
            "country_code": "US",
            "telephone_number": "844-994-6633",
            "fax_number": "470-300-7913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOEFSTEDT",
        "first_name": "BRET",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-05",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.